Individual
DR. ALICE M CONDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7023 OLD JAHNKE RD, RICHMOND, VA 23225-4126
(804) 320-1353
(804) 320-6636
Mailing address
7023 OLD JAHNKE RD, RICHMOND, VA 23225-4126
(804) 320-1353
(804) 320-6636
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101038117
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1379455
UNITED HEALTHCARE ID
VA
01
—
1382952
FIRST HEALTH ID
VA
01
—
584786
AENTA/US HEALTHCARE ID
VA
Enumeration date
10/14/2005
Last updated
04/20/2020
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