MEDICARE: ANN S. CONNAGHAN M.D.

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	207Q00000X	Family Medicine Physician	AC043757	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OZ91013	OTHER	MI	BLUE CROSS & BLUE SHIEL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609869106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN S. CONNAGHAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 779
Second Line	:
City	:	TAWAS CITY
State	:	MI
Zip	:	48764-0779
Country	:	US
Telephone Number	:	989-797-1041
Fax Number	:	989-799-0256

Provider Business Practice Location Address
First Line	:	5821 COLONY DR N
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48638
Country	:	US
Telephone Number	:	989-797-1041
Fax Number	:	989-799-0256

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	04/06/2021

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Directions to “ ANN S. CONNAGHAN M.D.” Practice Location

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