Provider Demographics
NPI:1255341475
Name:COLLECTOR, DANIEL HUGH (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HUGH
Last Name:COLLECTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BUSH CABIN CT
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-8807
Mailing Address - Country:US
Mailing Address - Phone:410-357-0709
Mailing Address - Fax:
Practice Address - Street 1:35 E PADONIA RD
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2306
Practice Address - Country:US
Practice Address - Phone:410-683-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD070101700Medicaid
MD070101700Medicaid
862LMedicare ID - Type Unspecified