Individual
DR. CHARLES DAVID COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2530 S TELSHOR BLVD, SUITE #207, LAS CRUCES, NM 88011-4951
(575) 556-6400
(575) 556-6405
Mailing address
PO BOX 6310, LAS CRUCES, NM 88006-6310
(575) 556-6400
(575) 556-6405
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2003-0073
NM
2086X0206X
Surgical Oncology Physician
2003-0073
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48582832
—
NM
01
—
P00892129
RR MEDICARE
NM
Enumeration date
11/29/2005
Last updated
04/11/2016
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