Provider Demographics
NPI:1134103534
Name:CONROY, SEAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:M
Last Name:CONROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6535 ROCHESTER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1362
Mailing Address - Country:US
Mailing Address - Phone:248-813-0060
Mailing Address - Fax:248-813-0066
Practice Address - Street 1:6535 ROCHESTER RD STE 102
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1362
Practice Address - Country:US
Practice Address - Phone:248-813-0060
Practice Address - Fax:248-813-0066
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072727208VP0000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H94975Medicare UPIN
SC072727Medicare ID - Type Unspecified