Provider Demographics
NPI:1972544401
Name:NEWHOUSE, PATRICIA ANN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:NEWHOUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 OSBORN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1884
Mailing Address - Country:US
Mailing Address - Phone:906-635-4654
Mailing Address - Fax:
Practice Address - Street 1:509 OSBORN BLVD
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-2069
Practice Address - Country:US
Practice Address - Phone:906-253-2605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD41221208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3040548Medicaid
TN4134429OtherBCBS
TN3040548Medicaid
TN4134429OtherBCBS