Provider Demographics
NPI:1386632255
Name:CONLEY, MICHAEL P (MD,FACOG)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:CONLEY
Suffix:
Gender:M
Credentials:MD,FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 N BEERS ST
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1519
Mailing Address - Country:US
Mailing Address - Phone:732-739-2500
Mailing Address - Fax:
Practice Address - Street 1:704 N BEERS ST
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1519
Practice Address - Country:US
Practice Address - Phone:732-739-2500
Practice Address - Fax:732-888-2778
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA54410207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5180309Medicaid
NJ0271053000OtherAMERIHEALTH
NJ0K4838OtherHEALTHNET
NJMP095OtherOXFORD
NJ0K4838OtherHEALTHNET
NJ054114BKLMedicare PIN