Healthcare Provider Details

I. General information

NPI: 1316010192
Provider Name (Legal Business Name): MICHAEL SEAN CONLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL S CONLEY M.D., P.C. MD

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W PONCE DE LEON AVE STE 1045
DECATUR GA
30030-2420
US

IV. Provider business mailing address

315 W PONCE DE LEON AVE SUITE 360
DECATUR GA
30030-2400
US

V. Phone/Fax

Practice location:
  • Phone: 404-681-4100
  • Fax: 404-681-2300
Mailing address:
  • Phone: 404-681-4100
  • Fax: 404-681-2300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number043583
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: