Individual
MARC CONNERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
170 BRACKEN PKWY, HOBART, IN 46342-6789
(219) 942-7156
Mailing address
PO BOX 1076, CROWN POINT, IN 46308-1076
(219) 662-3931
(219) 663-6359
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01049420A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000354497
ANTHEM
IN
05
—
200330540
—
IN
Enumeration date
08/01/2005
Last updated
09/09/2011
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