MEDICARE: DR. JOHN MICHAEL CONNOR DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	OS007102E	PA

General Provider Information

NPI Number	:	1447201546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MICHAEL CONNOR DO

Provider Business Mailing Address
First Line	:	12934 THE TERRACE
Second Line	:
City	:	HAGERSTOWN
State	:	MD
Zip	:	21742-2917
Country	:	US
Telephone Number	:	301-790-0420
Fax Number	:

Provider Business Practice Location Address
First Line	:	7008 AUGUSTA NATIONAL
Second Line	:
City	:	FAYETTEVILLE
State	:	PA
Zip	:	17222-9418
Country	:	US
Telephone Number	:	717-401-0539
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	01/31/2020

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