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Individual

MICHAEL JOHN CONNOLLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10945 N PORT WASHINGTON RD STE 201, MEQUON, WI 53092-5078
(262) 292-3151
Mailing address
10945 N PORT WASHINGTON RD STE 201, MEQUON, WI 53092-5078
(262) 292-3151

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA12003700
NJ
2085R0202X
Diagnostic Radiology Physician
72289
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
74869
WI
2085R0202X
Diagnostic Radiology Physician
74869-20
WI
2085R0202X
Diagnostic Radiology Physician
E-17247
AR
2085R0202X
Diagnostic Radiology Physician
MD-23870
HI

Other

Enumeration date
04/15/2015
Last updated
06/11/2025
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