Provider Demographics
NPI:1952563462
Name:KOLLINS, KEVIN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:MICHAEL
Last Name:KOLLINS
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 1:480 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
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012475712080P0202X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology