Provider Demographics
NPI:1780793430
Name:COLLINS, DEIRDRE MURRAY (MD)
Entity type:Individual
Prefix:DR
First Name:DEIRDRE
Middle Name:MURRAY
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 1:735 FITZWATERTOWN RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1332
Mailing Address - Country:US
Mailing Address - Phone:215-657-2012
Mailing Address - Fax:215-657-2018
Practice Address - Street 1:735 FITZWATERTOWN RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1332
Practice Address - Country:US
Practice Address - Phone:215-657-2012
Practice Address - Fax:215-657-2018
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046387L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017109680001Medicaid
PA231952978OtherTAX ID
PA7217075OtherAETNA
719588OtherHIGHMARK BLUE SHIELD
PA0048674000OtherIBC
0171096801OtherAMERI CHOICE
PA02334MD046387LOtherHEALTH PARTNERS
PA1111553OtherKEYSTONE MERCY
PA3384600OtherCIGNA
PA390005904OtherRAILROAD MEDICARE
PA0017109680001Medicaid
PA719588Medicare PIN