Healthcare Provider Details
I. General information
NPI: 1396247532
Provider Name (Legal Business Name): LISA MARIA CONTE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/04/2018
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US
IV. Provider business mailing address
8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US
V. Phone/Fax
- Phone: 301-319-0451
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0102205829 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 0102205829 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: