Individual
SCOTT COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-864
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010507276
TAX ID
ME
01
—
047836
ANTHEM
ME
01
—
1120990001
DMERC
ME
01
—
30333267
NH MEDICAID
NH
01
—
3690583
AETNA HMO
ME
05
—
424650099
—
ME
01
—
7554653
AETNA NON-HMO
ME
01
—
P00239889
RR MEDICARE
ME
Enumeration date
06/26/2006
Last updated
07/21/2015
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