Provider Demographics
NPI:1508865494
Name:NEWMAN, ELIZABETH A (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:SLITER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3600 RODEO LN
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-6400
Mailing Address - Country:US
Mailing Address - Phone:505-474-6097
Mailing Address - Fax:505-471-4503
Practice Address - Street 1:3600 RODEO LN
Practice Address - Street 2:SUITE A-2
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-6400
Practice Address - Country:US
Practice Address - Phone:505-629-4400
Practice Address - Fax:505-474-4277
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0427781207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM28484347Medicaid
KS100328460CMedicaid
KS058632Medicare PIN
KSG81599Medicare UPIN
NM28484347Medicaid
NM271315YLKBMedicare PIN