Provider Demographics
NPI:1629003314
Name:NEWMAN, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10030 EDISON SQUARE DR NW
Practice Address - Street 2:STE 100A
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8308
Practice Address - Country:US
Practice Address - Phone:704-403-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35449207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1629003314Medicaid
SCN35449Medicaid
NC8962385Medicaid
NC2173454DMedicare PIN
NCF33058Medicare UPIN
SCN35449Medicaid
NCNC9938AMedicare PIN
NC2173454EMedicare PIN
NC2173454Medicare PIN