Provider Demographics
NPI:1760525612
Name:NEWMAN, TODD DAVIS (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:DAVIS
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 195
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MN
Mailing Address - Zip Code:55721-0195
Mailing Address - Country:US
Mailing Address - Phone:218-820-7936
Mailing Address - Fax:
Practice Address - Street 1:10 W HIGHWAY 2 STE A
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MN
Practice Address - Zip Code:55721-8614
Practice Address - Country:US
Practice Address - Phone:218-820-7936
Practice Address - Fax:218-545-2185
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN71M99CROtherBCBS CLINIC ID NUMBER
MN72M00NEOtherBCBS INDIVIDUAL PROVIDER
MN689452600Medicaid
MN689452600Medicaid
MN72M00NEOtherBCBS INDIVIDUAL PROVIDER
MNC03618Medicare ID - Type UnspecifiedCLINIC ID NUMBER