Provider Demographics
NPI:1093717621
Name:CONTI, MARISA (DO)
Entity type:Individual
Prefix:DR
First Name:MARISA
Middle Name:
Last Name:CONTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 SAVANNAH RD FL 2
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1675
Mailing Address - Country:US
Mailing Address - Phone:302-645-3499
Mailing Address - Fax:302-644-4830
Practice Address - Street 1:32050 LONG NECK RD
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-6228
Practice Address - Country:US
Practice Address - Phone:302-645-3150
Practice Address - Fax:833-908-2232
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0008719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1093717621Medicaid
DE053568OtherMEDICARE GROUP ID
DE053568OtherMEDICARE GROUP ID