Individual
CARL G CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
875 8TH ST NE, MASSILLON, OH 44646-8503
(330) 832-8761
(330) 834-4756
Mailing address
875 EIGHTH STREE NE, MASSILLON, OH 44646
(330) 832-8761
(330) 837-4756
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35085474
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353942
ANTHEM
—
05
—
2549639
—
OH
01
—
P00201891
MEDICARE RAILROAD
—
Enumeration date
05/25/2006
Last updated
06/16/2021
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