Provider Demographics
NPI:1679791230
Name:CONNOR, ANN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
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 1:1080 COUNTY RD D W
Mailing Address - Street 2:APT. 24
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55126-3766
Mailing Address - Country:US
Mailing Address - Phone:651-483-3048
Mailing Address - Fax:
Practice Address - Street 1:1080 COUNTY RD D W
Practice Address - Street 2:APT. 24
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55126-3766
Practice Address - Country:US
Practice Address - Phone:651-483-3048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0027657207ZP0102X
WI38916207ZP0102X
CAG88471207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology