Doctor Name: | DR. DAVID S. COLLOM |
NPI Number: | 1174545388 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | PO2997 |
Business Practice Address: | 701 Enterprise Rd E Suite 910 Safety Harbor, FL - 346955350 |
Business Phone Number: | 7277966900 |
Business Fax Number: | 7276698417 |
Mailing Address: | 701 Enterprise Rd E, Suite 910 SAFETY HARBOR |
State: | FL |
Postal Code: | 346955350 |
Phone Number: | 7277966900 |
Fax Number: | 7276698417 |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 01/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | PO2997 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |