Provider Demographics
NPI:1619920899
Name:NEWMAN, MARK ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLAN
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 WILLOWBANK ST
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-2822
Mailing Address - Country:US
Mailing Address - Phone:814-355-4889
Mailing Address - Fax:814-355-4891
Practice Address - Street 1:817 WILLOWBANK ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-2822
Practice Address - Country:US
Practice Address - Phone:814-355-4889
Practice Address - Fax:814-355-4891
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004664L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PANE664192OtherBLUE SHIELD
PANE664192OtherBLUE SHIELD