Individual
DEBRA CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9901 MEDICAL CENTER DR, ROCKVILLE, MD 20850-3357
(301) 279-6550
Mailing address
7316 NORMANDY DR, RICHMOND, VA 23229-6712
(804) 282-2612
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
D0062563
MD
207P00000X
Emergency Medicine Physician
0101035903
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235154238
—
VA
01
—
235836
BLUE SHIELD
VA
01
—
235837
BLUE SHIELD
VA
Enumeration date
07/12/2006
Last updated
01/07/2011
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