Provider Demographics
NPI:1275913568
Name:NEWKIRK, LOIS GERALDINE
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:GERALDINE
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 INCHEAPE CIRCLE
Mailing Address - Street 2:APT 2D
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:443-804-4690
Mailing Address - Fax:410-654-4849
Practice Address - Street 1:205 INCHEAPE CIRCLE
Practice Address - Street 2:APT 2D
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117
Practice Address - Country:US
Practice Address - Phone:443-804-4690
Practice Address - Fax:410-654-4849
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00040984251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare