Doctor Name: | BRIAN KONRADT |
NPI Number: | 1417311861 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 100212 |
Business Practice Address: | 5016 Capulet Cir Myrtle Beach, SC - 295887720 |
Business Phone Number: | 8436857534 |
Business Fax Number: | |
Mailing Address: | 5016 Capulet Circle, MYRTLE BEACH |
State: | SC |
Postal Code: | 29588 |
Phone Number: | 8436197518 |
Fax Number: | |
NPI Enumeration Date: | 04/12/2016 |
NPI Last Update Date: | 05/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 343900000X |
License Number: | 100212 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | SC |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Non-emergency Medical Transport (VAN) |
Taxonomy Specialization: | |
Taxonomy Definition: | A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |