Individual
DR. JONATHAN MARK COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7903 PROVIDENCE RD, SUITE 100, CHARLOTTE, NC 28277-9720
(704) 316-4460
(704) 316-4466
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200001102
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89131Y8
—
NC
Enumeration date
04/07/2006
Last updated
03/18/2015
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