Provider Demographics
NPI:1598851636
Name:NEWAY, MODEL N/A (MD)
Entity Type:Individual
Prefix:DR
First Name:MODEL
Middle Name:N/A
Last Name:NEWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 PINE HEIGHTS DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-2843
Mailing Address - Country:US
Mailing Address - Phone:404-812-9941
Mailing Address - Fax:
Practice Address - Street 1:3112 PINE HEIGHTS DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-2843
Practice Address - Country:US
Practice Address - Phone:404-812-9941
Practice Address - Fax:404-812-9942
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038570207PE0004X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F86852Medicare UPIN