Connelly, Marcus George
Connelly, Marcus George is an individual health care provider with primary practice located at 600 Coffee Rd , Modesto CA 95355-4201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Connelly, Marcus George can be contacted via phone (209) 521-6097.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | C50251 | California |
Profile Details
| NPI number | 1295703577 |
|---|---|
| LBN Legal business name | Connelly, Marcus George |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 10th, 2006 |
| Last updated | Nov 1st, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295703577 | NPPES |
| California | MEDICAID | 00C502510 |
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