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NPI Code Detail

MEDICARE: DR. PATRICK F CONRAD MD

MEDICARE: DR. PATRICK F 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
1207P00000XEmergency Medicine PhysicianME73998FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2059185375OTHERALBCBS PROVIDER NUMBER
342539OTHERFLBCBS PROVIDER NUMBER
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205889524
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK F CONRAD MD
Provider Business Mailing Address
First Line : PO BOX 88490
Second Line :
City : CHICAGO
State : IL
Zip : 60680-1490
Country : US
Telephone Number : 205-437-6098
Fax Number : 205-437-5998
Provider Business Practice Location Address
First Line : 2190 HIGHWAY 85 N
Second Line :
City : NICEVILLE
State : FL
Zip : 32578-1045
Country : US
Telephone Number : 850-729-9490
Fax Number : 205-437-5998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 06/25/2009

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Directions to “ DR. PATRICK F CONRAD MD” Practice Location

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