Individual
DR. MARK STEPHEN CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 MICHIGAN AVE NW, SUITE M4800, WASHINGTON, DC 20010-2916
(202) 476-6817
Mailing address
111 MICHIGAN AVE NW, SUITE M4800, WASHINGTON, DC 20010-2916
(202) 476-6817
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2014-00895
NC
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD043066
DC
Other
Enumeration date
05/26/2011
Last updated
06/15/2015
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