Provider Demographics
NPI:1750340766
Name:CONTI, CAROLINA GUECO (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:GUECO
Last Name:CONTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 W WELLS ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-1918
Mailing Address - Country:US
Mailing Address - Phone:414-431-2888
Mailing Address - Fax:414-431-4288
Practice Address - Street 1:1930 W WELLS ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1918
Practice Address - Country:US
Practice Address - Phone:414-431-2888
Practice Address - Fax:414-431-4288
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32552500Medicaid
WI000173791Medicare PIN
WIG95249Medicare UPIN