Individual
DR. PHILIP G CONRARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7620 W BURLEIGH ST, MILWAUKEE, WI 53222-5002
(414) 444-6000
(888) 664-5360
Mailing address
7620 W BURLEIGH ST, MILWAUKEE, WI 53222-5002
(414) 444-6000
(888) 664-5360
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
37204-020
WI
207LP2900X
Pain Medicine (Anesthesiology) Physician
036124777
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
30724-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050059549
RAIL ROAD MEDICARE
—
05
—
31916700
—
WI
Enumeration date
11/23/2005
Last updated
06/22/2015
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