Provider Demographics
NPI:1528063096
Name:COLLINS, BEVERLY ANN (MD, MBA, MS)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:ANN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD, MBA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2725
Mailing Address - Country:US
Mailing Address - Phone:410-528-5006
Mailing Address - Fax:
Practice Address - Street 1:100 S CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-2725
Practice Address - Country:US
Practice Address - Phone:410-528-5006
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00315542083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine