Provider Demographics
NPI:1518966951
Name:NEWMAN, ALAN BRYAN (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:BRYAN
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25500 MEADOWBROOK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1879
Mailing Address - Country:US
Mailing Address - Phone:248-465-4340
Mailing Address - Fax:248-465-4341
Practice Address - Street 1:25500 MEADOWBROOK RD STE 120
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1879
Practice Address - Country:US
Practice Address - Phone:248-465-4340
Practice Address - Fax:248-465-4341
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301067888207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI423105110Medicaid
MI0F36022084Medicare ID - Type Unspecified
MI423105110Medicaid