Provider Demographics
NPI:1467271528
Name:PEDIATRIC CARDIOLOGY OF WINCHESTER, LLC
Entity type:Organization
Organization Name:PEDIATRIC CARDIOLOGY OF WINCHESTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PEDIATRIC CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KOLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-686-1514
Mailing Address - Street 1:480 W JUBAL EARLY DR STE 320
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6449
Mailing Address - Country:US
Mailing Address - Phone:540-686-1514
Mailing Address - Fax:540-686-1516
Practice Address - Street 1:480 W JUBAL EARLY DR STE 320
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6449
Practice Address - Country:US
Practice Address - Phone:540-686-1514
Practice Address - Fax:540-686-1516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty