Individual
WILLIAM ROBERT CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
720 S VAN BUREN ST, SUITE 301, GREEN BAY, WI 54301-3538
(920) 433-9400
(920) 433-9409
Mailing address
720 S VAN BUREN ST, SUITE 301, GREEN BAY, WI 54301-3538
(920) 433-9400
(920) 433-9409
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1794-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41994800
—
WI
Enumeration date
08/12/2005
Last updated
07/08/2007
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