Provider Demographics
NPI:1659339075
Name:NEWMAN, MICHAEL BENNETT (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BENNETT
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 E STONEY HILL CT
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-1937
Mailing Address - Country:US
Mailing Address - Phone:215-752-0781
Mailing Address - Fax:
Practice Address - Street 1:603 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5528
Practice Address - Country:US
Practice Address - Phone:215-968-6700
Practice Address - Fax:215-504-8373
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001564L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0023118000OtherKEYSTONE EAST
PASC001564LOtherPA. LISCENSE-PODIATRIC
PA1149894OtherKEYSTONE MERCY
PA0016221400005Medicaid
PA1149894OtherKEYSTONE MERCY
PAT30575Medicare UPIN