Provider Demographics
NPI:1215357421
Name:NEWMAN, SAMANTHA MYERS (MD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MYERS
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:MYERS
Other - Last Name:CALLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:45 MURRAH ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-9304
Mailing Address - Country:US
Mailing Address - Phone:803-640-1866
Mailing Address - Fax:
Practice Address - Street 1:3651 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6521
Practice Address - Country:US
Practice Address - Phone:706-651-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-27
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA148492207P00000X
FLME141650207P00000X
IL036142810207P00000X
NV17866207P00000X
OH35.132726207P00000X
AZ52783207P00000X
GA84206207P00000X
IN01081798A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ199620Medicaid
CA177EPD1QMedicaid