DR. DOUGLAS MICHAEL CONRAD (NPI# 1467676510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467676510 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS MICHAEL CONRAD |
| Credential | MD |
| Practice Address |
4505 Fairmeadow Ln Suite 208 Raleigh NC 27607-6449 |
| Practice Telephone | 9197824954 |
| Practice Fax Number | 9197824849 |
| Mailing Telephone | 9197824954 |
| Mailing Fax Number | 9197824849 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
20252 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 23893 | 01 | |
| NC | 8923893 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780605378 | Douglas John Conrad | Internal Medicine | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2006-07-21 |
| Street Address |
4505 FAIRMEADOW LN SUITE 208 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821366402 | Yvette Figueroa | Psychiatry & Neurology | 3801 Lake Boone Trail, Suite 150, Raleigh, NC 27607 | 2011-12-09 |
| 1245465053 | Herman Aronov Naftel | Psychiatry & Neurology | 107 Sunnybrook Road, Raleigh, NC 27610 | 2009-05-22 |
| 1346397833 | Hima B Palakurthi | Psychiatry & Neurology | 5904 Norwood Knolls Way, Raleigh, NC 27614-8296 | 2007-01-05 |
| 1427066802 | Laura Earle Horgan | Psychiatry & Neurology | Msc, Raleigh, NC 27699-3601 | 2006-08-03 |
| 1497230775 | Restoration Counseling Center | Psychiatry & Neurology | 5868 Faringdon Pl, Raleigh, NC 27609-3931 | 2018-10-02 |
| 1033582002 | Abdul Khalid, Md, Pa | Psychiatry & Neurology | 312 W Millbrook Rd, Raleigh, NC 27609-4389 | 2015-11-12 |
| 1619292471 | National Mentor Healthcare, LLC | Psychiatry & Neurology | 3125 Poplarwood Ct, Suite 300, Raleigh, NC 27604-1084 | 2010-04-05 |
| 1275742579 | Thomas Matthews Haizlip | Psychiatry & Neurology | 820 S Boylan Ave, Scott Building, Raleigh, NC 27603-2246 | 2007-05-22 |
| 1396950630 | Ellison & Associates of Raleigh PC | Psychiatry & Neurology | 2920 Highwoods Blvd, Suite 127, Raleigh, NC 27604-1015 | 2007-05-11 |
| 1528103819 | Gerald Bruce Sibrack | Psychiatry & Neurology | 1100 Navaho Drive, Suite 105, Raleigh, NC 27609 | 2007-02-21 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on DR. DOUGLAS MICHAEL CONRAD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.