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: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1980
NORFOLK VA
23501-1980
US

IV. Provider business mailing address

2405 DAVIS AVE
ALEXANDRIA VA
22302-3209
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-0369
  • Fax:
Mailing address:
  • Phone:
  • 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: