Proctor, Conrad A

Proctor, Conrad A is an individual health care provider with primary practice located at 2251 N Squirrel Rd Suite 105, Auburn Hills MI 48326-4600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Proctor, Conrad A can be contacted via phone (248) 648-8100.

Contact Information

Primary practice address
2251 N Squirrel Rd Suite 105 Auburn Hills MI 48326-4600
Phone: (248) 648-8100
Fax: (248) 648-8060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 4301023795 Michigan

Profile Details

NPI number 1841271624
LBN Legal business name Proctor, Conrad A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Sep 26th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841271624 NPPES
Other 040637019 BCBSM
MEDICAID 4354759 TYPE 10 BCBSM

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