Connolly, Michael Edward

Connolly, Michael Edward is an individual health care provider with primary practice located at 612 N 11Th St , Quincy IL 62301-2662. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Connolly, Michael Edward can be contacted via phone (217) 224-9484.

Contact Information

Primary practice address
612 N 11Th St Quincy IL 62301-2662
Phone: (217) 224-9484
Fax: (217) 224-7950
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 45217 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34949 Iowa
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-108107 Illinois

Profile Details

NPI number 1538110960
LBN Legal business name Connolly, Michael Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Jan 9th, 2017 - about 8 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 1538110960 NPPES
Wisconsin MEDICAID 34328300

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