Provider Demographics
NPI:1740586569
Name:NEWMAN, GREGORY MARSHALL (MA)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:MARSHALL
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:GREG
Other - Middle Name:
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:2000 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47306-1022
Mailing Address - Country:US
Mailing Address - Phone:765-285-8160
Mailing Address - Fax:765-285-5623
Practice Address - Street 1:2000 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47306-1022
Practice Address - Country:US
Practice Address - Phone:765-285-8160
Practice Address - Fax:765-285-5623
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002468A237600000X
OHA-00993237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter