Provider Demographics
NPI:1063471720
Name:NEWLAND, PATRICIA K (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:K
Last Name:NEWLAND
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 1:800 COLONIAL CIR
Mailing Address - Street 2:STE 200
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-9637
Mailing Address - Country:US
Mailing Address - Phone:515-285-3200
Mailing Address - Fax:515-285-3232
Practice Address - Street 1:800 COLONIAL CIR
Practice Address - Street 2:STE 200
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-9637
Practice Address - Country:US
Practice Address - Phone:515-285-3200
Practice Address - Fax:515-285-3232
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA32528207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1163964Medicaid
IA1063471720Medicaid
IA719260442Medicare PIN
IAG57440Medicare UPIN
IA18867Medicare PIN
IA080159555Medicare PIN