Provider Demographics
NPI:1023062254
Name:MICHAEL E. NEWMAN DPM
Entity type:Organization
Organization Name:MICHAEL E. NEWMAN DPM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-646-5990
Mailing Address - Street 1:1018 N BETHLEHEM PIKE
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2186
Mailing Address - Country:US
Mailing Address - Phone:215-646-5990
Mailing Address - Fax:215-646-2901
Practice Address - Street 1:1018 N BETHLEHEM PIKE
Practice Address - Street 2:SUITE C-2
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2186
Practice Address - Country:US
Practice Address - Phone:215-646-5990
Practice Address - Fax:215-646-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002887L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
579953Medicare PIN