Provider Demographics
NPI:1104942085
Name:COLLINS, EMILIE A (MD)
Entity type:Individual
Prefix:
First Name:EMILIE
Middle Name:A
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5060 CASCADE RD SE STE C-1
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3808
Mailing Address - Country:US
Mailing Address - Phone:616-255-9521
Mailing Address - Fax:616-255-9627
Practice Address - Street 1:300 LAFAYETTE SE
Practice Address - Street 2:STE 2045
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503
Practice Address - Country:US
Practice Address - Phone:616-685-3098
Practice Address - Fax:616-685-3095
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301080409207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine