Provider Demographics
NPI:1013166974
Name:CONROY, RUSHIKA M (MD)
Entity type:Individual
Prefix:
First Name:RUSHIKA
Middle Name:M
Last Name:CONROY
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 1:41 DONALD B DEAN DR STE A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3252
Mailing Address - Country:US
Mailing Address - Phone:207-661-6064
Mailing Address - Fax:
Practice Address - Street 1:41 DONALD B DEAN DR STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3252
Practice Address - Country:US
Practice Address - Phone:207-661-6064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220139072080P0205X
MEMD243482080B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity Medicine
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology