Provider Demographics
NPI:1679575419
Name:NEWMAN, WILLIAM T (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
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:RR 12 BOX 100
Mailing Address - Street 2:SUITE C
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-9347
Mailing Address - Country:US
Mailing Address - Phone:724-837-8877
Mailing Address - Fax:724-837-3967
Practice Address - Street 1:RR 12 BOX 100
Practice Address - Street 2:SUITE C
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9347
Practice Address - Country:US
Practice Address - Phone:724-837-8877
Practice Address - Fax:724-837-3967
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036499E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012060730002Medicaid
PA0012060730002Medicaid