Provider Demographics
NPI:1801537071
Name:COLLIS, REID WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:REID
Middle Name:WILLIAM
Last Name:COLLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 LEE ST.
Mailing Address - Street 2:BOX 801007
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-243-5600
Mailing Address - Fax:434-244-9450
Practice Address - Street 1:1215 LEE ST.
Practice Address - Street 2:BOX '801007'
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-243-5600
Practice Address - Fax:434-244-9450
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program