Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 1206 | MA |
NPI | 1003805235 |
---|---|
Provider Name | Donna M Collins |
First Address | Waltham, MA 02451-1991 |
Second Address | Taunton, MA 02780-2465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 20/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P28199 | (02) |