Provider Demographics
NPI:1144252248
Name:CONNOR, MARIA B (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:B
Last Name:CONNOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:S WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-0001
Mailing Address - Country:US
Mailing Address - Phone:781-803-2786
Mailing Address - Fax:781-843-3809
Practice Address - Street 1:340 WOOD RD STE 101
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2404
Practice Address - Country:US
Practice Address - Phone:781-843-0705
Practice Address - Fax:781-843-3809
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA160095207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ21896OtherBC/BS
MA3195741Medicaid
MA160095OtherTAHP
MA69417OtherHPHC
MA160095OtherTAHP
MAMX3017OtherMEDICARE PTAN #
G96763Medicare UPIN