Individual
DR. EDWARD CONRAD MICHAUD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR, BROOKE ARMY MEDICAL CENTER, FORT SAM HOUSTON, TX 78234-4504
(210) 916-4587
Mailing address
3551 ROGER BROOKE DR, BROOKE ARMY MEDICAL CENTER, FORT SAM HOUSTON, TX 78234-4504
(210) 916-4587
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA05889700
NJ
208M00000X
Hospitalist Physician
Primary
25MA05889700
NJ
Other
Enumeration date
06/19/2006
Last updated
02/01/2013
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