Provider Demographics
NPI:1831141548
Name:NEWMAN, ALFRED JACKSON III (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:JACKSON
Last Name:NEWMAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-841-8151
Mailing Address - Fax:704-841-9228
Practice Address - Street 1:1700 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4658
Practice Address - Country:US
Practice Address - Phone:704-841-8151
Practice Address - Fax:704-841-9228
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200400562207R00000X, 207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1361POtherBLUE CROSS/BLUE SHIELD
NC891361PMedicaid
NC1361POtherBLUE CROSS/BLUE SHIELD
NCI12961Medicare UPIN
NCNCA756BMedicare UPIN