Provider Demographics
NPI:1568450112
Name:CONANT, RICHARD H (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:H
Last Name:CONANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:H
Other - Last Name:CONANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5530 WISCONSIN AVE
Mailing Address - Street 2:SUITE # 1660
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-657-9876
Mailing Address - Fax:301-664-5979
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE # 1660
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-657-9876
Practice Address - Fax:301-664-5979
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDOOO1815174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB94617Medicare UPIN
MD409382Medicare ID - Type Unspecified