Provider Demographics
NPI:1487027751
Name:NEWTON, SHAWNIKA
Entity Type:Individual
Prefix:
First Name:SHAWNIKA
Middle Name:
Last Name:NEWTON
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 1:7238 MCCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7252
Mailing Address - Country:US
Mailing Address - Phone:443-239-5172
Mailing Address - Fax:
Practice Address - Street 1:7238 MCCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-7252
Practice Address - Country:US
Practice Address - Phone:443-239-5172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-08
Last Update Date:2015-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4363225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant