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NPI Code Detail

MEDICARE: MR. JOSEPH CARLOS CONRAD CRNA

MEDICARE: MR. JOSEPH CARLOS CONRAD CRNA
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
1367500000XCertified Registered Nurse Anesthetist143454NC

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 : 1902892839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH CARLOS CONRAD CRNA
Provider Business Mailing Address
First Line : PO BOX 4174
Second Line :
City : ASHEBORO
State : NC
Zip : 27204-4174
Country : US
Telephone Number : 336-683-5284
Fax Number : 336-683-5279
Provider Business Practice Location Address
First Line : 364 WHITE OAK ST
Second Line :
City : ASHEBORO
State : NC
Zip : 27203-5434
Country : US
Telephone Number : 336-683-5284
Fax Number : 336-683-5279
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 05/06/2008

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