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Individual

MAUREEN CONNOLLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
77 VICTOR ST, HIGHLAND PARK, MI 48203
(313) 365-3338
(313) 365-3305
Mailing address
77 VICTOR ST, HIGHLAND PARK, MI 48203-3127
(313) 365-3338
(313) 365-3305

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301108535
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629331939
MI
Enumeration date
06/21/2012
Last updated
07/17/2018
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