Mccollum, Dave

Mccollum, Dave is an individual health care provider with primary practice located at 500 S Maple St , Waconia MN 55387-1752. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Mccollum, Dave can be contacted via phone (952) 442-2191.

Contact Information

Primary practice address
500 S Maple St Waconia MN 55387-1752
Phone: (952) 442-2191
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 25697 Minnesota

Profile Details

NPI number 1154360808
LBN Legal business name Mccollum, Dave
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Dec 4th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154360808 NPPES
Other 0C319MC BCBS
Other 0235010 BCBS
Other 39-03774 BCBS
MEDICAID 933800400 BCBS
Other HP13930 BCBS
Other 106062 BCBS

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