Provider Demographics
NPI:1578590113
Name:NEWMAN, CARL T (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:T
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 1:1220 MARLATT AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-7310
Mailing Address - Country:US
Mailing Address - Phone:785-539-1787
Mailing Address - Fax:785-539-0890
Practice Address - Street 1:1220 MARLATT AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-7310
Practice Address - Country:US
Practice Address - Phone:785-539-1787
Practice Address - Fax:785-539-0890
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17895208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100327380AMedicaid
KS054451OtherBLUE CROSS BLUE SHIELD OF KANSASW
KS054451OtherBLUE CROSS BLUE SHIELD OF KANSASW
KSB68936Medicare UPIN