Individual
MICHAEL CONNOR SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 793-5000
Mailing address
677 CHURCH ST NE STE 100, MARIETTA, GA 30060-1101
(770) 422-2326
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
29347
SC
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
RN313506
GA
Other
Enumeration date
01/23/2023
Last updated
09/12/2025
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