Mccollum, Michael J

Mccollum, Michael J is an individual health care provider with primary practice located at 1008 Minnequa Ave , Pueblo CO 81004-3733. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mccollum, Michael J can be contacted via phone (719) 542-7891.

Contact Information

Primary practice address
1008 Minnequa Ave Pueblo CO 81004-3733
Phone: (719) 542-7891
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 42869 Colorado

Profile Details

NPI number 1003891060
LBN Legal business name Mccollum, Michael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Nov 5th, 2020 - about 5 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 1003891060 NPPES
Colorado MEDICAID 90725361

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