Individual
DR. CHARLES WILLIAM CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
120 COLLEGE AVE, SOMERVILLE, MA 02144-1919
(617) 776-2500
(617) 776-3850
Mailing address
120 COLLEGE AVE, SOMERVILLE, MA 02144-1919
(781) 593-1700
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1784
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361968
—
MA
01
—
2700037
UNITED HEALTHCARE
MA
01
—
33386
HARVARD PILGRIM HEALTH CA
MA
01
—
709158
TUFTS HEALTH PLAN
MA
01
—
Y70860
BLUE SHIELD OF MA
MA
Enumeration date
06/23/2005
Last updated
04/24/2012
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