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General NPI Number Information
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NPI Number | 1245489632
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Entity Type | Organization
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Legal Business Name | MATTHEW H. CONRAD, MD, PA
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 1700 WATERFRONT PKWY BLDG 200
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City | WICHITA
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State | KS
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Zip | 67206-6614
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Country | US
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Telephone | 316-681-2227
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Fax | 316-684-5250
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Provider Business Mailing Address
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Address Line | 1700 WATERFRONT PKWY BUILDING 200
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City | WICHITA
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State | KS
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Zip | 67206-6614
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Country | US
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Telephone | 316-681-2227
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Fax | 316-684-5250
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | KRISTIN K CONRAD
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Credential | RN
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Telephone | 316-681-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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