Provider Demographics
NPI:1609834605
Name:NEWMAN, IAN (DC CCSP)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DC CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4398
Mailing Address - Country:US
Mailing Address - Phone:301-696-8888
Mailing Address - Fax:301-696-9618
Practice Address - Street 1:198 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 12
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4398
Practice Address - Country:US
Practice Address - Phone:301-696-8888
Practice Address - Fax:301-696-9618
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01626111N00000X
FLCH6753111N00000X
HIDC654111N00000X
CADC22789111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD965QMedicare ID - Type Unspecified
U73629Medicare UPIN