Provider Demographics
NPI:1154301331
Name:NEWMAN, GERALD W (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:W
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 1:2002 MEDICAL PKWY
Mailing Address - Street 2:SUITE 650
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3046
Mailing Address - Country:US
Mailing Address - Phone:410-224-8001
Mailing Address - Fax:410-224-8002
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:SUITE 650
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3046
Practice Address - Country:US
Practice Address - Phone:410-224-8001
Practice Address - Fax:410-224-8002
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD40092207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207N00000XAllopathic & Osteopathic PhysiciansDermatology
Not Answered207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD40092OtherMARYLAND STATE LISC. #
MD52056311OtherCAREFIRST
MDBN2641391OtherDEA NUMBER
MDBN2641391OtherDEA NUMBER
MD409RMedicare ID - Type Unspecified