Individual
DR. CONRAD A PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2251 N SQUIRREL RD, SUITE 105, AUBURN HILLS, MI 48326-4600
(248) 648-8100
(248) 648-8060
Mailing address
2251 N SQUIRREL RD, SUITE 105, AUBURN HILLS, MI 48326-4600
(248) 648-8100
(248) 648-8060
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301023795
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040637019
BCBSM
—
05
—
4354759 TYPE 10
—
MI
Enumeration date
11/09/2005
Last updated
09/26/2011
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