Provider Demographics
NPI:1205807591
Name:COLLINS, CHRISTOPHER M (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1222 S PATTERSON BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2684
Mailing Address - Country:US
Mailing Address - Phone:937-496-2600
Mailing Address - Fax:937-496-2610
Practice Address - Street 1:1222 S PATTERSON BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2684
Practice Address - Country:US
Practice Address - Phone:937-496-2600
Practice Address - Fax:937-496-2610
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35083735D207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2473078Medicaid
7971558OtherAETNA
2393846OtherUNITEDHEALTHCARE
000000325604OtherANTHEM
D83735OtherHUMANA
000000325604OtherANTHEM
CO4129851Medicare PIN
I04060Medicare UPIN