Individual provider · Type 1 NPI

Ethan Conroy, PAC

Surgical Physician Assistant · St. Paul, MN

NPI number 1023089547 Active

Practice location

17 Exchange St W, Suite 222
St. Paul, MN 55102-1045

Call (651) 224-7854 Map

Mailing address

1516 Holton St
St. Paul, MN 55108-2326

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X9849 (MN)
Surgical Physician Assistant Primary 363AS0400X9849 (MN)

Surgical Physician Assistant: Definition to come...

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About NPI 1023089547

Ethan Conroy, PAC's National Provider Identifier is 1023089547, issued on Feb 1, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in St. Paul, MN. The record was last updated on Oct 30, 2014.