Provider Demographics
NPI:1316091358
Name:COLLINS, KATHLEEN LORETTA (MD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:LORETTA
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1204 FERDON RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-3635
Mailing Address - Country:US
Mailing Address - Phone:734-623-0132
Mailing Address - Fax:
Practice Address - Street 1:1150 W MEDICAL CENTER DR
Practice Address - Street 2:3510D MSRB I
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-0799
Practice Address - Country:US
Practice Address - Phone:734-615-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301073190207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease