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Individual

DR. CHARLES WILLIAM CONNOLLY

Active
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Individual

DR. CHARLES WILLIAM CONNOLLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1784
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0361968
MA
01
2700037
UNITED HEALTHCARE
MA
01
33386
HARVARD PILGRIM HEALTH CA
MA
01
709158
TUFTS HEALTH PLAN
MA
01
Y70860
BLUE SHIELD OF MA
MA
Enumeration date
06/23/2005
Last updated
04/24/2012
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