Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 8598 | SC |
NPI | 1013904838 |
---|---|
Provider Name | Dr. Ronald L Collins |
First Address | Columbia, SC 29204-2409 |
Second Address | Columbia, SC 29204-2409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 01/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
085981 | (05) | SC |
D90821 | (02) |