Healthcare Provider Details

I. General information

NPI: 1811073489
Provider Name (Legal Business Name): EDWARD J CONLEY DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3494 BEECHER RD
FLINT MI
48532
US

IV. Provider business mailing address

G3494 BEECHER RD SUITE A
FLINT MI
48532
US

V. Phone/Fax

Practice location:
  • Phone: 810-230-8677
  • Fax: 810-230-7855
Mailing address:
  • Phone: 810-230-8677
  • Fax: 810-230-7855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD J CONLEY
Title or Position: PRESIDENT
Credential: DO
Phone: 810-230-8677