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Individual
MATHIAS A KOLLECK II
Active
Individual
MATHIAS A KOLLECK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
01052471A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109144
BCBS - ER MARY STREET
IN
01
—
000000173755
BCBS - CARE GROUP MARY ST
IN
01
—
000000386245
BCBS - CARE GROUP GATEWAY
IN
05
—
64014269
—
KY
Enumeration date
07/12/2006
Last updated
07/09/2007
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