Provider Demographics
NPI:1245379148
Name:CONLON, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CONLON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 WASHINGTON ST
Mailing Address - Street 2:STE 6
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-2045
Mailing Address - Country:US
Mailing Address - Phone:781-383-1616
Mailing Address - Fax:781-383-8686
Practice Address - Street 1:340 WASHINGTON ST
Practice Address - Street 2:STE 6
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-2045
Practice Address - Country:US
Practice Address - Phone:781-383-1616
Practice Address - Fax:781-383-8686
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002095OtherTUFTS HEALTH PLAN
MA4400385OtherUNITED HEALTH CARE
MA043407854OtherPHCS
MA2055093OtherAETNA HEALTH CARE
MAY36474OtherBLUE CROSS BLUE SHIELD
MAB20756501OtherCIGNA HEALTH CARE
MAY39745OtherBLUE CROSS BLUE SHIELD
MA350297OtherHARVARD PILGRIM HEALTH
MA1611852Medicaid
MA043407854OtherNEIGHBORHOOD HEALTH
MA043407854OtherNEIGHBORHOOD HEALTH
MAB20756501OtherCIGNA HEALTH CARE