Individual
MADELINE CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10500 MONTGOMERY RD, MONTGOMERY, OH 45242-4402
(513) 865-1111
Mailing address
7933 SCHOOL HOUSE LN, MONTGOMERY, OH 45242-5928
(513) 235-8258
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.007495RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0462231
—
OH
Enumeration date
03/02/2022
Last updated
03/30/2022
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