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Individual

HAROLD A CONRAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
35 MICHIGAN NE, SUITE 4150, GRAND RAPIDS, MI 49503
(616) 267-2100
(616) 267-2101
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
4301071191
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0M74460050
MEDICARE ID
MI
01
1558407189
GROUP NPI
MI
01
1922090554
GROUP NPI
MI
05
3389769
MI
01
350D176310
BCBS GROUP
MI
Enumeration date
01/24/2006
Last updated
01/04/2022
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