Individual
DR. DOUGLAS MICHAEL CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4505 FAIRMEADOW LN, SUITE 208, RALEIGH, NC 27607-6449
(919) 782-4954
(919) 782-4849
Mailing address
4505 FAIRMEADOW LN, SUITE 208, RALEIGH, NC 27607-6449
(919) 782-4954
(919) 782-4849
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
20252
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23893
BLUE CROSS BLUE SHIELD
—
05
—
8923893
—
NC
Enumeration date
04/12/2007
Last updated
07/08/2007
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