Provider Demographics
NPI:1245257856
Name:COLLINS, SAVITA P (MD)
Entity type:Individual
Prefix:DR
First Name:SAVITA
Middle Name:P
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2012 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-5200
Mailing Address - Country:US
Mailing Address - Phone:574-534-2025
Mailing Address - Fax:574-534-2542
Practice Address - Street 1:2012 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-5200
Practice Address - Country:US
Practice Address - Phone:574-534-2025
Practice Address - Fax:574-534-2542
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062378A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01062378BOtherCONTROLLED SUBSTANCE REG
IN01062378AOtherLICENSE
INBC5119575OtherDEA
INBC5119575OtherDEA