Provider Demographics
NPI:1699355073
Name:NEWCOME, ELLE MAUREEN (MD (MAY 2021))
Entity Type:Individual
Prefix:
First Name:ELLE
Middle Name:MAUREEN
Last Name:NEWCOME
Suffix:
Gender:F
Credentials:MD (MAY 2021)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N 12TH ST STE 508
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2849
Mailing Address - Country:US
Mailing Address - Phone:602-839-3927
Mailing Address - Fax:602-839-4233
Practice Address - Street 1:1300 N 12TH ST STE 508
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2849
Practice Address - Country:US
Practice Address - Phone:602-839-3927
Practice Address - Fax:602-839-4233
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program