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General NPI Number Information
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NPI Number | 1730187030
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Entity Type | Individual
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Provider Name | RICHARD CONOVER MEAD PT
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Gender | Male
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 02/14/2018
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Provider Practice Location Address
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Address Line | 141 THOMAS JOHNSON DR STE 180
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City | FREDERICK
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State | MD
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Zip | 21702-4509
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Country | US
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Telephone | 301-620-7478
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Fax | 301-620-7479
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Provider Business Mailing Address
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Address Line | 501 FAIRMOUNT AVE STE 302
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City | TOWSON
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State | MD
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Zip | 21286-5494
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Country | US
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Telephone | 410-927-8768
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Fax | 410-648-4878
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305203943
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 16283
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11085
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4488
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 2305203943
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License Number State | VA
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