Provider Demographics
NPI:1912941899
Name:COLLUM, ROBERT G (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:COLLUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:404 LIPPINCOTT DR STE 317
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:16 POCONO ROAD
Practice Address - Street 2:SUITE 317
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-627-2650
Practice Address - Fax:973-627-8383
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2021-12-10
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06600200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1K3274OtherHEALTH NET
223297079OtherBCBS
223297079OtherHORIZON HEALTHCARE ADM
4977236007OtherCIGNA HEALTHCARE
NJ8393508Medicaid
223297079OtherMEDICARE BLUE HMO BLUE
4977236007OtherCIGNA
NJ110189724OtherRAILROAD MEDICARE
223297079OtherBLUE SHIELD OF NJ
223297079OtherHMO BLUE
78020564426360OtherBLUE CHOICE NJ PLUS POS
2136430OtherAETNA
85682OtherEMPIRE BLUE CHOICE PPO
NJP908927OtherOXFORD
2010098000OtherAMERIHEALTH
223297079OtherBLUE CROSS OF CONNETICUT
856821OtherWELLCHOICE
2010098000OtherKEYSTONE HEALTH EAST
4977236007OtherCIGNA HEALTHCARE
1K3274OtherHEALTH NET