Individual
CONRAD JOSEPH ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
400 E 3RD ST, MAILDROP: 1S2W50, DULUTH, MN 55805-1951
(218) 786-3985
(218) 786-3018
Mailing address
4687 COUNTY ROAD 13, MOOSE LAKE, MN 55767-8109
(218) 485-4479
(218) 786-3918
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9581
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41921600
—
WI
05
—
659411500
—
MN
Enumeration date
04/17/2006
Last updated
04/29/2011
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