Healthcare Provider Details

I. General information

NPI: 1760587414
Provider Name (Legal Business Name): RICHARD MICHAEL CONRAN MD, PHD, JD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

2405 DAVIS AVE
ALEXANDRIA VA
22302-3209
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-3454
  • Fax:
Mailing address:
  • Phone: 301-295-3454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number158989-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number158989-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: