Connolly, Mary J

Connolly, Mary J is an individual health care provider with primary practice located at 100 Foden Road, East Suite 203, South Portland ME 04106-2327. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Connolly, Mary J can be contacted via phone (207) 874-1489.

Contact Information

Primary practice address
100 Foden Road, East Suite 203 South Portland ME 04106-2327
Phone: (207) 874-1489
Fax: (207) 523-8590
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD18621 Maine
Allopathic & Osteopathic Physicians / General Practice 208D00000X 232521 Massachusetts

Profile Details

NPI number 1558535559
LBN Legal business name Connolly, Mary J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2008
Last updated Jul 24th, 2012 - about 12 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 1558535559 NPPES
New Hampshire MEDICAID 32000562

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