Brian A Connolly, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301033502 Issued in MI

Practice address

189 Townsend St
Ste 300
Birmingham, MI 48009-6008

Phone

(248) 642-3737

Fax

(248) 642-1083

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1104815208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 TOWNSEND ST",
            "address_2": "STE 300",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096008",
            "telephone_number": "248-642-3737",
            "fax_number": "248-642-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 TOWNSEND ST",
            "address_2": "STE 300",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096008",
            "telephone_number": "248-642-3737",
            "fax_number": "248-642-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "BRIAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301033502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dereck Coe, LMT
• Jacqueline Meier Coffman, DO
• Madison Collins
• Gigi Anna Colombini, LMSW
• Comfort Family Care LLC
• Mary L Connolly, MSW
• Steven Anthony Conyers, MA
• Elizabeth Ann Corby, PH.D.
• John Charles Cordes, DC
• Carly Corpolongo, LMSW

• Psychiatry Physician in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.