Provider Demographics
NPI:1457382715
Name:COLLINS, WENDY JANE (MD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:JANE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9 INDUSTRIAL RD
Mailing Address - Street 2:STE 5
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3736
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:508-473-1210
Practice Address - Street 1:68A MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1775
Practice Address - Country:US
Practice Address - Phone:508-533-6020
Practice Address - Fax:508-533-6640
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2024-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA157060208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ22439OtherBCBS
MA0106500Medicaid
MA0106500Medicaid