Ethan Conroy is a Medical in Saint Paul, Minnesota. Ethan Conroy practices all healthcare services and medical treatments related to Medical. The NPI Number for Ethan Conroy is 1023089547. The last update date is 2014-10-30.
Ethan Conroy's current location address is 1516 Holton St, Saint Paul, Minnesota. You can contact this provider via phone number 6516443119. The mailing address for Ethan Conroy is 1516 Holton St, Saint Paul, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ethan Conroy |
|---|---|
| Address | 1516 Holton St, Saint Paul, Minnesota |
| Phone Number | 6516443119 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1023089547 |
|---|---|
| Provider Enumeration Date | 2006-02-01 |
| Last Updated Date | 2014-10-30 |
Provider Mailing Address Detail
| Address | 1516 Holton St |
|---|---|
| City | Saint Paul |
| State | Minnesota (MN) |
| Post Code | 551082326 |
| Phone Number | 6516443119 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 9849 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 923192700 | MN | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Ethan Conroy by the Centers for Medicare & Medicaid Services?
The Ethan Conroy has been assigned the NPI (National Provider Identifier) 1023089547. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Ethan Conroy is geographically located?
The Ethan Conroy is physically situated at the following location: 1516 Holton St, Saint Paul, MN, 551082326.
What is the area of specialization for Ethan Conroy, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Ethan Conroy is Medical, and the corresponding taxonomy code that categorizes this area of expertise is 363Am0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1023089547 to Ethan Conroy?
The Centers for Medicare & Medicaid Services originally issued the 1023089547 to Ethan Conroy on 2006-02-01.
As of what date were the Ethan Conroy's details last updated?
The information pertaining to the Ethan Conroy, including its address, specialty, and other details, was most recently updated on 2014-10-30.
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