Individual
TIMOTHY J CONROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 LAFAYETTE AVE SE STE 400, GRAND RAPIDS, MI 49503-4677
(616) 486-6870
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301049565
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558407189
GROUP NPI
MI
05
—
1860983
—
MI
01
—
1922090554
GROUP NPI
MI
01
—
3504119182
BCBSM
MI
Enumeration date
01/19/2006
Last updated
02/02/2024
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