Provider Demographics
NPI:1477528297
Name:NEWMAN, NICHOLAS C (DO)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:C
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE., ML 5026
Mailing Address - Street 2:CHILDREN'S HOSPITAL MEDICAL CENTER
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-7722
Mailing Address - Fax:513-636-3737
Practice Address - Street 1:3333 BURNET AVE., ML 5026
Practice Address - Street 2:CHILDREN'S HOSPITAL MEDICAL CENTER
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-636-7722
Practice Address - Fax:513-636-3737
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.009335208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5315007445OtherBOARD OF PHARMACY
MI5101013382OtherPHYSICIAN LICENSE
MI4312220 TYPE 11Medicaid
MI4312220 TYPE 11Medicaid