Provider Demographics
NPI:1700841160
Name:NEWSTADT, ROBYN O (MD)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:O
Last Name:NEWSTADT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:2355 POPLAR LEVEL RD
Practice Address - Street 2:G-1, #11
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1384
Practice Address - Country:US
Practice Address - Phone:502-636-8121
Practice Address - Fax:502-636-8128
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY28595207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000350821OtherANTHEM / NCMA
KY50005561OtherPASSPORT / NCMA
KY64285950Medicaid
KY1184174OtherCHA / NCMA
KY000014952UOtherHUMANA / NCMA
KY048235OtherSIHO / NCMA
KY1741718OtherCIGNA / NCMA
KY2446865000OtherPASSPORT ADVANTAGE / NCMA
KYP00176877OtherRAILROAD MEDICARE
KY1184174OtherCHA / NCMA
KYP00176877OtherRAILROAD MEDICARE