Provider Demographics
NPI:1336123330
Name:COLLINS, COLLEEN MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:MARIA
Last Name:COLLINS
Suffix:
Gender:F
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:PO BOX 2895
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-2895
Mailing Address - Country:US
Mailing Address - Phone:907-224-2273
Mailing Address - Fax:907-224-8501
Practice Address - Street 1:PO BOX 2895
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-2895
Practice Address - Country:US
Practice Address - Phone:907-224-2273
Practice Address - Fax:907-224-8501
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK241531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3112888Medicaid
MAJ14192OtherBCBS MA
MAJ14192OtherBCBS MA
MA3112888Medicaid
MA071453OtherTUFTS HEALTH PLAN