Provider Demographics
NPI:1750635330
Name:CONRAD, ELIZABETH TIERNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:TIERNEY
Last Name:CONRAD
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Gender:F
Credentials:MD
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Mailing Address - Street 1:6862 ELM ST
Mailing Address - Street 2:SUITE 720
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3897
Mailing Address - Country:US
Mailing Address - Phone:703-635-2158
Mailing Address - Fax:703-356-1610
Practice Address - Street 1:6862 ELM ST
Practice Address - Street 2:SUITE 720
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3897
Practice Address - Country:US
Practice Address - Phone:703-635-2158
Practice Address - Fax:703-356-1610
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2014-01-10
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Provider Licenses
StateLicense IDTaxonomies
VA0101052045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine