Provider Demographics
NPI:1346234929
Name:NEWMAN, PAUL G (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:G
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 REED ST
Mailing Address - Street 2:STE 102
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6410
Mailing Address - Country:US
Mailing Address - Phone:507-387-3441
Mailing Address - Fax:507-387-2899
Practice Address - Street 1:600 REED ST
Practice Address - Street 2:STE 102
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6410
Practice Address - Country:US
Practice Address - Phone:507-387-3441
Practice Address - Fax:507-387-2899
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
MN1298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7525273Medicaid
MN259KOWEOtherBCBS
MN259KOWEOtherBCBS