Individual
TRACY M COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9100 COLUMBIA AVENUE, MUNSTER, IN 46321-2907
(219) 836-5040
(219) 836-6835
Mailing address
9660 WICKER AVE, SAINT JOHN, IN 46373-9487
(219) 836-5040
(219) 836-6835
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01041366A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000081279
ANTHEM BCBS
IN
05
—
100096670
—
IN
Enumeration date
07/29/2005
Last updated
05/14/2010
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