Provider Demographics
NPI:1982231841
Name:NEWSOME, NOAH THOMAS (DPM)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:THOMAS
Last Name:NEWSOME
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:38400 TAMARAC BLVD APT 106
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-8122
Mailing Address - Country:US
Mailing Address - Phone:440-856-5210
Mailing Address - Fax:
Practice Address - Street 1:3925 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1738
Practice Address - Country:US
Practice Address - Phone:716-250-9999
Practice Address - Fax:716-250-6555
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY007302213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery