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NPI Code Detail

MEDICARE: MICHAEL P CONRAD MD

MEDICARE: MICHAEL P CONRAD MD
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
12084P0800XPsychiatry PhysicianME0055242FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
108727OTHERBCBS

General Provider Information

NPI Number : 1124063474
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL P CONRAD MD
Provider Business Mailing Address
First Line : 1221 E DESOTO ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-3337
Country : US
Telephone Number : 850-437-9997
Fax Number : 850-439-2122
Provider Business Practice Location Address
First Line : 1221 E DESOTO ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-3337
Country : US
Telephone Number : 850-437-9997
Fax Number : 850-439-2122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 07/08/2007

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Directions to “ MICHAEL P CONRAD MD” Practice Location

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