Individual
SUSAN C CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8414 NAAB RD, INDIANAPOLIS, IN 46260-1972
(317) 338-1600
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01071294A
IN
2084E0001X
Epilepsy Physician
01071294A
IN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
01071294A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001083944
ANTHEM PTAN
IN
01
—
1102417813
ANTHEM PTAN
IN
05
—
201109650
—
IN
Enumeration date
05/26/2009
Last updated
03/06/2025
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