Provider Demographics
NPI:1548215007
Name:SUND, NEWMAN JOSHUA (MD)
Entity Type:Individual
Prefix:
First Name:NEWMAN
Middle Name:JOSHUA
Last Name:SUND
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 1:6115 FALLS RD
Mailing Address - Street 2:300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2219
Mailing Address - Country:US
Mailing Address - Phone:410-377-7611
Mailing Address - Fax:410-377-8221
Practice Address - Street 1:6115 FALLS RD
Practice Address - Street 2:300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2219
Practice Address - Country:US
Practice Address - Phone:410-377-7611
Practice Address - Fax:410-377-8221
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0067464207W00000X
PAMD433493207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD018325300Medicaid
PA130196N2EMedicare Oscar/Certification
PAP00736810Medicare Oscar/Certification
MDP00651505Medicare Oscar/Certification
MD018325300Medicaid
MD129674ZACZMedicare Oscar/Certification