Provider Demographics
NPI:1427366681
Name:MCNEW, DUSTIN ROBERT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:ROBERT
Last Name:MCNEW
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:7401 BLACKMON RD
Mailing Address - Street 2:APARTMENT 3609
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-4489
Mailing Address - Country:US
Mailing Address - Phone:423-521-0034
Mailing Address - Fax:706-243-4356
Practice Address - Street 1:3465 D MACON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-2582
Practice Address - Country:US
Practice Address - Phone:706-243-3051
Practice Address - Fax:706-243-2027
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
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Provider Licenses
StateLicense IDTaxonomies
GA005935363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant