Provider Demographics
NPI:1760408371
Name:REED, CONRAD CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:CONRAD
Middle Name:CHRISTOPHER
Last Name:REED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 OLD YORK RD
Mailing Address - Street 2:STE 121
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3840
Mailing Address - Country:US
Mailing Address - Phone:215-517-1200
Mailing Address - Fax:215-517-1219
Practice Address - Street 1:1235 OLD YORK RD
Practice Address - Street 2:STE 121
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3840
Practice Address - Country:US
Practice Address - Phone:215-517-1200
Practice Address - Fax:215-517-1219
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066019L207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017412760004Medicaid
PA025772GPJMedicare ID - Type Unspecified
PA0017412760004Medicaid