Provider Demographics
NPI:1316056567
Name:CONTE, EUGENE (DO)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:CONTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN
Mailing Address - Street 2:STE 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7176
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:8940 KINGSRIDGE DR
Practice Address - Street 2:STE 104
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-1632
Practice Address - Country:US
Practice Address - Phone:937-436-1433
Practice Address - Fax:937-439-7443
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003451207N00000X
AZ1889207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0523482Medicaid
OH0523482Medicaid
OHA80656Medicare UPIN