Provider Demographics
NPI:1932634813
Name:NEWSOME, DAVID BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BENJAMIN
Last Name:NEWSOME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4200 HOUMA BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2970
Mailing Address - Country:US
Mailing Address - Phone:504-454-7878
Mailing Address - Fax:
Practice Address - Street 1:701 METAIRIE RD STE 2A208
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4061
Practice Address - Country:US
Practice Address - Phone:504-832-0646
Practice Address - Fax:504-832-2530
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA311081207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine