Provider Demographics
NPI:1093772162
Name:NEWMAN, CHARLES L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:L
Last Name:NEWMAN
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 1:419 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5101
Mailing Address - Country:US
Mailing Address - Phone:256-547-6331
Mailing Address - Fax:256-547-1711
Practice Address - Street 1:419 S 5TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5101
Practice Address - Country:US
Practice Address - Phone:256-547-6331
Practice Address - Fax:256-547-1711
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19195208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51536510OtherBC & BS OF AL
AL51025556OtherBC & BS OF AL
AL000025556Medicaid
AL000128501Medicaid
AL51025556OtherBC & BS OF AL
AL000025556Medicare ID - Type Unspecified