Individual
MARY J CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 FODEN ROAD, EAST, SUITE 203, SOUTH PORTLAND, ME 04106-2327
(207) 874-1489
(207) 523-8590
Mailing address
100 GANNETT DR STE C, SOUTH PORTLAND, ME 04106-5900
(207) 347-2947
(207) 874-2317
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18621
ME
208D00000X
General Practice Physician
232521
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32000562
—
NH
Enumeration date
04/22/2008
Last updated
03/03/2026
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