Provider Demographics
NPI:1912017724
Name:BUI, CONRAD C (DC)
Entity Type:Individual
Prefix:DR
First Name:CONRAD
Middle Name:C
Last Name:BUI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219
Mailing Address - Country:US
Mailing Address - Phone:303-922-2977
Mailing Address - Fax:303-922-2044
Practice Address - Street 1:845 S FEDERAL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219
Practice Address - Country:US
Practice Address - Phone:303-922-8146
Practice Address - Fax:303-922-0158
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO353418Medicare ID - Type Unspecified