Provider Demographics
NPI:1548429343
Name:NEWLIN, ENOBONG (MD)
Entity Type:Individual
Prefix:
First Name:ENOBONG
Middle Name:
Last Name:NEWLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ENOBONG
Other - Middle Name:
Other - Last Name:AMAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:201 E WENDOVER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1205
Mailing Address - Country:US
Mailing Address - Phone:336-832-4444
Mailing Address - Fax:336-832-4445
Practice Address - Street 1:201 E WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1205
Practice Address - Country:US
Practice Address - Phone:336-832-4444
Practice Address - Fax:336-832-4445
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine