Provider Demographics
NPI:1033146543
Name:NEWMAN, ROXANNE V (MD)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:V
Last Name:NEWMAN
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:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 BROADWAY N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-3641
Practice Address - Country:US
Practice Address - Phone:701-234-2254
Practice Address - Fax:701-234-3769
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND65942086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
11664OtherNDBC
1812524OtherMEDICA
1000188OtherPREFERRED ONE
ND17737Medicaid
MN227563500Medicaid
HP16851OtherHEALTHPARTNERS
2T792NEOtherMNBC
MN227563500Medicaid
HP16851OtherHEALTHPARTNERS