Ross, Conrad Joseph

Ross, Conrad Joseph is an individual health care provider with primary practice located at 400 E 3Rd St Maildrop: 1S2W50, Duluth MN 55805-1951. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Ross, Conrad Joseph can be contacted via phone (218) 786-3985.

Contact Information

Primary practice address
400 E 3Rd St Maildrop: 1S2W50 Duluth MN 55805-1951
Phone: (218) 786-3985
Fax: (218) 786-3018
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 9581 Minnesota

Profile Details

NPI number 1093779852
LBN Legal business name Ross, Conrad Joseph
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Apr 29th, 2011 - about 15 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 1093779852 NPPES
Wisconsin MEDICAID 41921600
Wisconsin MEDICAID 659411500

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