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Individual

DR. CONRAD C NIEVERA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 E 5TH AVE, SPOKANE, WA 99202-1334
(509) 838-2531
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649
(509) 838-2531

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
35243
WI
2084N0400X
Neurology Physician
MD60209370
WA
2084N0600X
Clinical Neurophysiology Physician
Primary
MD60209370
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003806261C
HUMANA
05
34312700
WI
Enumeration date
05/17/2006
Last updated
10/09/2012
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