Provider Demographics
NPI:1235336843
Name:MCCONNON, MICHAEL LANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LANE
Last Name:MCCONNON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2940 HEALTH PKWY
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-9342
Mailing Address - Country:US
Mailing Address - Phone:989-953-5320
Mailing Address - Fax:989-953-5329
Practice Address - Street 1:2940 HEALTH PKWY
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-9342
Practice Address - Country:US
Practice Address - Phone:989-953-5320
Practice Address - Fax:989-953-5329
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2016-09-21
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Provider Licenses
StateLicense IDTaxonomies
MI4301104698207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine