Provider Demographics
NPI:1891739785
Name:NEWTON, EDWARD MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MARSHALL
Last Name:NEWTON
Suffix:
Gender:M
Credentials:MD
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 13955
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29422-3955
Mailing Address - Country:US
Mailing Address - Phone:843-766-7696
Mailing Address - Fax:843-556-5882
Practice Address - Street 1:1477 TOBIAS GADSON BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407
Practice Address - Country:US
Practice Address - Phone:843-766-7696
Practice Address - Fax:843-556-5882
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC19206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC080162052OtherRR MEDICARE
SC080180707OtherRR MEDICARE
SCP00727217OtherRAILROAD MEDICARE ID-RSFPP
SC192062Medicaid
SCG583299223Medicare PIN
SC1740230028Medicare PIN
SCG583297096Medicare PIN
SCG583296795Medicare PIN
SC080162052OtherRR MEDICARE
SC080180707OtherRR MEDICARE
SCP00727217OtherRAILROAD MEDICARE ID-RSFPP