Provider Demographics
NPI:1184752511
Name:NEWMAN, MARK C (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:C
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 1:3 GREEN TER
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3630
Mailing Address - Country:US
Mailing Address - Phone:732-531-4420
Mailing Address - Fax:
Practice Address - Street 1:103 PARKER RD
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764
Practice Address - Country:US
Practice Address - Phone:732-870-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA32356207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53122Medicare UPIN
NJ087776Medicare ID - Type Unspecified