Provider Demographics
NPI:1457393423
Name:COLLINS, SEAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MICHAEL
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4300 HOUMA BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2932
Mailing Address - Country:US
Mailing Address - Phone:504-412-1600
Mailing Address - Fax:504-780-8922
Practice Address - Street 1:4300 HOUMA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2932
Practice Address - Country:US
Practice Address - Phone:504-412-1600
Practice Address - Fax:504-780-8922
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY236156208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09774082Medicaid
LA1483605Medicaid
LA1483605Medicaid
LAH81449Medicare UPIN