Provider Demographics
NPI:1952509176
Name:NEWMAN FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:NEWMAN FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCSP
Authorized Official - Phone:301-696-8888
Mailing Address - Street 1:198 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21727
Mailing Address - Country:US
Mailing Address - Phone:301-696-8888
Mailing Address - Fax:301-696-9618
Practice Address - Street 1:198 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 12
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21727
Practice Address - Country:US
Practice Address - Phone:301-696-8888
Practice Address - Fax:301-696-9618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO1626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
965QMedicare ID - Type Unspecified
U73629Medicare UPIN