Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 16450 | MA |
Y | 213EG0000X | General Practice | 16450 | MA |
NPI | 1003820416 |
---|---|
Provider Name | James M Collins |
First Address | Shelburne Falls, MA 01370 |
Second Address | Shelburne Falls, MA 01370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |