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Individual

DWIGHT D COLLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6013 NW 32ND WAY, BOCA RATON, FL 33496-3364
(561) 305-8163
Mailing address
6013 NW 32ND WAY, BOCA RATON, FL 33496-3364
(561) 305-8163

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-122526
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036-122526
LICENSE NUMBER
IL
Enumeration date
02/11/2009
Last updated
07/12/2012
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