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NPI Code Detail

MEDICARE: MR. ANDREW JOSEPH CONLU M.D.

MEDICARE: MR. ANDREW JOSEPH CONLU M.D.
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
1207R00000XInternal Medicine Physician6600NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528018447
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW JOSEPH CONLU M.D.
Provider Business Mailing Address
First Line : PO BOX 230545
Second Line :
City : LAS VEGAS
State : NV
Zip : 89105-0545
Country : US
Telephone Number : 702-813-1602
Fax Number : 702-453-5741
Provider Business Practice Location Address
First Line : 94220 4TH ST
Second Line :
City : GOLD BEACH
State : OR
Zip : 97444-7756
Country : US
Telephone Number : 702-813-1602
Fax Number : 702-453-5741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 01/18/2023

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