Provider Demographics
NPI:1316010192
Name:CONLEY, MICHAEL SEAN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SEAN
Last Name:CONLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:S
Other - Last Name:CONLEY M.D., P.C.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:315 W PONCE DE LEON AVE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2400
Mailing Address - Country:US
Mailing Address - Phone:404-681-4100
Mailing Address - Fax:404-681-2300
Practice Address - Street 1:315 W PONCE DE LEON AVE
Practice Address - Street 2:SUITE 360
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030
Practice Address - Country:US
Practice Address - Phone:404-681-4100
Practice Address - Fax:404-681-2300
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0435832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000752606AMedicaid
GAGRP4459Medicare ID - Type Unspecified
GA000752606AMedicaid