Provider Demographics
NPI:1356436331
Name:CONTI, MICHAEL ANTHONY (DPM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:CONTI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8147
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-8147
Mailing Address - Country:US
Mailing Address - Phone:856-457-5148
Mailing Address - Fax:856-457-5190
Practice Address - Street 1:400 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-3910
Practice Address - Country:US
Practice Address - Phone:856-457-5148
Practice Address - Fax:856-457-5190
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2014-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00246500213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60022319OtherHORIZON NJ HEALTH
NJP00326327OtherRAILROAD MEDICARE
NJ2017065OtherGREAT WEST HEALTHCARE
NJ3478180OtherCIGNA
NJ91002229400OtherAMERICHOICE
NJS44426OtherAMERIHEALTH ADMINISTRATORS
NJ4384203OtherAETNA
NJ907901OtherUNITED HEALTHCARE
NJ0090263Medicaid
NJ2097786OtherFIRST HEALTH PPO
NJP3695100OtherOXFORD
NJ205211058OtherHORIZON HEALTHCARE
NJ2699960000OtherAMERIHEALTH, IBC, KEYSTONE
NJ3K3437OtherHEALTH NET
NJ2097786OtherFIRST HEALTH PPO
NJ205211058OtherHORIZON HEALTHCARE
NJ2699960000OtherAMERIHEALTH, IBC, KEYSTONE
NJ3K3437OtherHEALTH NET