Provider Demographics
NPI:1295229276
Name:NEWCOMB, BENJAMIN (MD PHD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:NEWCOMB
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MUSIC SQ W APT 545
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5614
Mailing Address - Country:US
Mailing Address - Phone:206-265-1600
Mailing Address - Fax:
Practice Address - Street 1:70 MUSIC SQ W APT 545
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5614
Practice Address - Country:US
Practice Address - Phone:206-265-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018021684207R00000X
TN64266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine