MEDICARE: CONRAD IBER MD

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
1	207RP1001X	Pulmonary Disease Physician	25658	MN

Other Identifiers

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

General Provider Information

NPI Number	:	1649225012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONRAD IBER MD

Provider Business Mailing Address
First Line	:	720 WASHINGTON AVE SE
Second Line	:	UNIVERSITY OF MINNESOTA PHYSICIANS
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414
Country	:	US
Telephone Number	:	612-884-0649
Fax Number	:

Provider Business Practice Location Address
First Line	:	606 24TH AVENUE SOUTH, SUITE 106
Second Line	:	UMP SLEEP MEDICINE CLINIC
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55454-1437
Country	:	US
Telephone Number	:	612-884-0649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	01/31/2019

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