Agustin, Conrado M
Agustin, Conrado M is an individual health care provider with primary practice located at 527 N Grove St , Wichita KS 67214-4520. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Agustin, Conrado M can be contacted via phone (316) 262-2415.Contact Information
Primary practice address
527 N Grove St
Wichita KS 67214-4520
Phone: (316) 262-2415
Fax: (316) 264-4734
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 04-30665 | Kansas |
Profile Details
| NPI number | 1558454686 |
|---|---|
| LBN Legal business name | Agustin, Conrado M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jan 18th, 2024 - about 10 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558454686 | NPPES |
| Kansas | MEDICAID | 30004493060004 |
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