Provider Demographics
NPI:1144233156
Name:NEWCOMB, WARD MELVIN (MD)
Entity Type:Individual
Prefix:
First Name:WARD
Middle Name:MELVIN
Last Name:NEWCOMB
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 1:3600 S LOGAN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3766
Mailing Address - Country:US
Mailing Address - Phone:303-432-7855
Mailing Address - Fax:303-732-7866
Practice Address - Street 1:3600 S LOGAN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3766
Practice Address - Country:US
Practice Address - Phone:303-432-7855
Practice Address - Fax:303-732-7866
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2010-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29844207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COB68644Medicare UPIN