Doctor Name: | DR. DAN P CONRAD |
NPI Number: | 1033113832 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM` |
License Number: | 142 |
Business Practice Address: | 2610 Jackson Blvd Rapid City, SD - 577023474 |
Business Phone Number: | 6053486180 |
Business Fax Number: | 6053489121 |
Mailing Address: | 2610 Jackson Blvd, RAPID CITY |
State: | SD |
Postal Code: | 577023474 |
Phone Number: | 6053486180 |
Fax Number: | 6053489121 |
NPI Enumeration Date: | 06/09/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 142 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |