MEDICARE: DR. DAN P CONRAD DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	142	SD

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

General Provider Information

NPI Number	:	1033113832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAN P CONRAD DPM

Provider Business Mailing Address
First Line	:	3641 STURGIS RD
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-0321
Country	:	US
Telephone Number	:	605-348-6180
Fax Number	:	605-348-9121

Provider Business Practice Location Address
First Line	:	3641 STURGIS RD
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-0321
Country	:	US
Telephone Number	:	605-348-6180
Fax Number	:	605-348-9121

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/15/2016

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