Individual
DR. CONRADO M AGUSTIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
527 N GROVE ST, WICHITA, KS 67214-4520
(316) 262-2415
(316) 264-4734
Mailing address
2318 E CENTRAL AVE, WICHITA, KS 67214-4436
(316) 262-2415
(316) 262-0318
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
04-30665
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004493060004
—
KS
Enumeration date
10/02/2006
Last updated
01/18/2024
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