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NPI Code Detail

MEDICARE: MICHAEL P CONRAD MD PA

MEDICARE: MICHAEL P CONRAD MD PA
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

General Provider Information

NPI Number : 1346417029
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL P CONRAD MD PA
Provider Business Mailing Address
First Line : 1221 EAST DESOTO STREET
Second Line :
City : PENSACOLA
State : FL
Zip : 32501
Country : US
Telephone Number : 850-437-9997
Fax Number : 850-439-2122
Provider Business Practice Location Address
First Line : 1221 EAST DESOTO STREET
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 : OWNER
Name : MICHAEL P CONRAD
Credential : MD
Telephone Number : 850-937-9997
Provider Enumeration Date : 05/13/2008
Last Update Date : 05/13/2008

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