Provider Demographics
NPI:1265640841
Name:NEWMAN, CARL D
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:D
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8416 GILLETTE ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2866
Mailing Address - Country:US
Mailing Address - Phone:913-485-6611
Mailing Address - Fax:913-438-5513
Practice Address - Street 1:8416 GILLETTE ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2866
Practice Address - Country:US
Practice Address - Phone:913-485-6611
Practice Address - Fax:913-438-5513
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant