Individual
DR. PETER CONRAD NG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 DRESSER CT, RALEIGH, NC 27609-7327
(919) 876-2010
(919) 954-0555
Mailing address
1101 DRESSER CT, RALEIGH, NC 27609-7327
(919) 876-2010
(919) 954-0555
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
200200427
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
200200427
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1318M
BCBS-NC
NC
05
—
891318M
—
NC
Enumeration date
07/28/2005
Last updated
08/12/2009
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