Individual
RICHARD G. MCCOLLUM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3998 RED LION RD, EMERGENCY DEPARTMENT, PHILADELPHIA, PA 19114-1436
(215) 612-4000
(215) 807-8235
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8166
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036150432
IL
207P00000X
Emergency Medicine Physician
2019031790
MO
207P00000X
Emergency Medicine Physician
MD427812
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024508
—
OR
01
—
07645
HEALTH PARTNERS
PA
01
—
101701845-01
AMERICHOICE -FT
PA
01
—
101701845-02
AMERICHOICE FF
PA
01
—
101701845-03
AMERICHOICE - FB
PA
05
—
1017018450001
—
PA
05
—
1017018450002
—
PA
05
—
1017018450003
—
PA
01
—
1882159
HIGHMARK BLUE SHIELD
PA
01
—
274408400
KEYSTONE, IBC
PA
01
—
30034608
KEYSTONE MERCY
PA
Enumeration date
07/05/2006
Last updated
03/24/2020
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