Michael R. Condaras, DC

Individual provider Active NPI Chiropractor · Charleston, WV

NPI 1669437174 · NPPES record last updated Feb 17, 2012

Key facts

NPI
1669437174
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
161 (WV)
Practice address
1202 Virginia St E
Charleston, WV 25301-2909
Phone
(304) 342-3323
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
161WVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Michael R. Condaras DCCC Chiropractor Past
since Oct 1, 1986
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 161 WV Yes

Addresses

Primary practice location

1202 Virginia St E
Charleston, WV 25301-2909

Mailing address

1202 Virginia St. E.
Charleston, WV 25301-2909
Phone (304) 342-3323

Other identifiers

IdentifierTypeStateIssuer
0131291000MedicaidWV

Other names

  • Dr. Michael R Condaras Professional name

Other providers in Charleston, WV

All providers in Charleston, WV · Chiropractor in West Virginia

Sources for this page

Verify at the official NPI Registry.