Provider Demographics
NPI:1619260486
Name:NEWSUM, NICHOLAS JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JOSEPH
Last Name:NEWSUM
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 1:801 N ORANGE AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-5202
Mailing Address - Country:US
Mailing Address - Phone:407-841-2100
Mailing Address - Fax:407-841-5705
Practice Address - Street 1:801 N ORANGE AVE STE 600
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-5202
Practice Address - Country:US
Practice Address - Phone:407-841-2100
Practice Address - Fax:407-841-5705
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME132115207X00000X, 207XS0106X
IL036.139984207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13851393OtherCAQH ID
FL021811600Medicaid
FLME132115OtherFL MEDICAL LICENSE
FLME132115OtherFL MEDICAL LICENSE