Provider Demographics
NPI:1700179249
Name:COLLINS, CHARLES MICHAEL JR (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MICHAEL
Last Name:COLLINS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:501 S COIT ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5220
Mailing Address - Country:US
Mailing Address - Phone:843-777-7825
Mailing Address - Fax:843-777-7850
Practice Address - Street 1:501 S COIT ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5220
Practice Address - Country:US
Practice Address - Phone:843-777-7825
Practice Address - Fax:843-777-7850
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37384207R00000X
SCMMD.37384 MD207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine