Provider Demographics
NPI:1205954427
Name:CONRAD, PAUL WILLIAN (MD PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WILLIAN
Last Name:CONRAD
Suffix:
Gender:M
Credentials:MD PHD
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Mailing Address - Street 1:300 OXFORD DR
Mailing Address - Street 2:STE 300
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2361
Mailing Address - Country:US
Mailing Address - Phone:412-683-5300
Mailing Address - Fax:412-621-4833
Practice Address - Street 1:300 OXFORD DR
Practice Address - Street 2:STE 300
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2361
Practice Address - Country:US
Practice Address - Phone:412-683-5300
Practice Address - Fax:412-349-8655
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
MI4301085989207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024896640001Medicaid
PAMD439710OtherSTATE LICENSE
PAMD439710OtherSTATE LICENSE