Individual
JACOB L CONROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-2673
Mailing address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
5151015440
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/20/2021
Last updated
04/27/2022
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