Individual
DANIEL WOLFE COLLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7 PLEASANT ST, HANOVER, NH 03755-2008
(603) 643-5748
Mailing address
7 PLEASANT ST, HANOVER, NH 03755-2008
(603) 643-5748
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
8614
NH
207ND0101X
MOHS-Micrographic Surgery Physician
8614
NH
207NS0135X
Procedural Dermatology Physician
8614
NH
208D00000X
General Practice Physician
Primary
8614
NH
Other
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
—
Enumeration date
02/11/2006
Last updated
10/14/2019
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