Provider Demographics
NPI:1194706275
Name:CONTI, SALVATORE (MD)
Entity type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:
Last Name:CONTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 HAL GREER BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-4114
Mailing Address - Country:US
Mailing Address - Phone:304-399-6501
Mailing Address - Fax:304-399-6528
Practice Address - Street 1:1400 HAL GREER BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-4114
Practice Address - Country:US
Practice Address - Phone:304-399-6501
Practice Address - Fax:304-399-6528
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5409174400000X
WV24090174400000X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL18989OtherBLUE CROSS/BLUE SHIELD
MO203803OtherBLUE CROSS/BLUE SHIELD
MO18990OtherBLUE CHOICE
MO203552716Medicaid
MO300041329OtherRAILROAD MEDICARE
MO203552716Medicaid
MOD10045Medicare UPIN
IL18989OtherBLUE CROSS/BLUE SHIELD
MO203803OtherBLUE CROSS/BLUE SHIELD