MEDICARE: MAUREEN ANNE CONNOLLY 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	207R00000X	Internal Medicine Physician	27523	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	32308	OTHER	IA	WELLMARK

General Provider Information

NPI Number	:	1881745461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN ANNE CONNOLLY M.D.

Provider Business Mailing Address
First Line	:	2460 TOWNCREST DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6622
Country	:	US
Telephone Number	:	319-338-7862
Fax Number	:	319-338-2517

Provider Business Practice Location Address
First Line	:	2460 TOWNCREST DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6622
Country	:	US
Telephone Number	:	319-338-7862
Fax Number	:	319-338-2517

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

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	10/17/2007

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Directions to “ MAUREEN ANNE CONNOLLY M.D.” Practice Location

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