Healthcare Provider Details

I. General information

NPI: 1457535155
Provider Name (Legal Business Name): MICHAEL S CONLEY M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2007
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 STE 360
DECATUR GA
30030-2491
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 TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number043583
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SEAN CONLEY
Title or Position: PRESIDENT
Credential: MD
Phone: 404-681-4100