# DANIEL WOLFE COLLISON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1235102922
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | 8614 | NH | — |
| 207ND0101X | MOHS-Micrographic Surgery Physician | 8614 | NH | — |
| 207NS0135X | Procedural Dermatology Physician | 8614 | NH | — |
| 208D00000X | General Practice Physician | 8614 | NH | Yes |

## Other

- **Enumeration date:** 02/11/2006
- **Last updated:** 10/14/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0002051 | — | VT |
| 01 | — | 008614 | TUFTS | — |
| 01 | — | 0106540Y0NH01 | ANTHEM PROVIDER \# | — |
| 01 | — | 070011185 | RAILROAD MEDICARE | — |
| 01 | — | 07502 | MVP | — |
| 01 | — | 20234 | MATTHEW THORNTON HP | — |
| 01 | — | 3083123 | AETNA HMO PROVIDER ID | — |
| 01 | — | 4248210 | AETNA PROVIDER ID | — |
| 01 | — | 7323862 | CIGNA NATIONAL PROVIDER | — |
| 05 | — | 80002051 | — | NH |
| 01 | — | E52148 | HARVARD PILGRIM | — |
| 01 | — | P378192 | OXFORD | — |