Provider Demographics
NPI:1700979945
Name:COLLINA, STEVEN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAMES
Last Name:COLLINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:196 W SPROUL RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2045
Mailing Address - Country:US
Mailing Address - Phone:610-328-8830
Mailing Address - Fax:
Practice Address - Street 1:4310 LONDONDERRY RD STE 1
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5302
Practice Address - Country:US
Practice Address - Phone:717-791-2620
Practice Address - Fax:717-791-2621
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2021-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD068731L207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH11679Medicare UPIN