Individual
SUSAN MARIA CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1105 SCHROCK RD, 200, COLUMBUS, OH 43229-1146
(614) 505-7633
(614) 847-1106
Mailing address
1105 SCHROCK RD, 200, COLUMBUS, OH 43229-1146
(614) 505-7633
(614) 847-1106
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101524
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291083700
—
FL
01
—
9358461
MCR GROUP
OH
Enumeration date
03/17/2006
Last updated
07/29/2015
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