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Individual
JOHN CHRISTIAN CONRAD JR.
Active
Individual
JOHN CHRISTIAN CONRAD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0110003758
VA
363AS0400X
Surgical Physician Assistant
Primary
0110003758
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043582422
INTOTAL
VA
01
—
540506332115
TRICARE/CHAMPUS
VA
01
—
P01072820
RAILROAD MEDICARE
VA
Enumeration date
02/01/2012
Last updated
01/27/2022
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