Provider Demographics
NPI:1487778015
Name:COLLIER, SAMANTHA LEE (MD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LEE
Last Name:COLLIER
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 1:7906 E 28TH DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2444
Mailing Address - Country:US
Mailing Address - Phone:303-333-0412
Mailing Address - Fax:303-716-6648
Practice Address - Street 1:KINDRED HEALTHCARE
Practice Address - Street 2:1920 HIGH ST.
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218
Practice Address - Country:US
Practice Address - Phone:303-331-5226
Practice Address - Fax:303-331-5220
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35674207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G75601Medicare UPIN