Provider Demographics
NPI:1003801325
Name:NEWMAN, TERENCE R (MD)
Entity type:Individual
Prefix:
First Name:TERENCE
Middle Name:R
Last Name:NEWMAN
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 1:1200 RALSTON AVE
Mailing Address - Street 2:DEPT. OF SURGERY
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-1396
Mailing Address - Country:US
Mailing Address - Phone:419-783-6944
Mailing Address - Fax:419-478-3441
Practice Address - Street 1:1200 RALSTON AVE
Practice Address - Street 2:DEPT. OF SURGERY
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-1396
Practice Address - Country:US
Practice Address - Phone:419-783-6944
Practice Address - Fax:419-478-3441
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35083084207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2436984Medicaid
OH7297550OtherAETNA
OH341893773-008OtherMMO
OH000000339095OtherANTHEM
OH04578OtherPHC
OHP00135976OtherRRMC
OH20-03236OtherUHC
OH000000339095OtherANTHEM
OH20-03236OtherUHC