Individual
DIANE K CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438
Mailing address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35045372
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0478460
—
OH
01
—
080042254
RAILROAD
OH
Enumeration date
06/10/2006
Last updated
05/19/2008
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