Provider Demographics
NPI:1255175576
Name:NEWLUN, DEMETRIUS KAHNE
Entity type:Individual
Prefix:
First Name:DEMETRIUS
Middle Name:KAHNE
Last Name:NEWLUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 TOWNSHIP ROAD 186 SW
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43748-9746
Mailing Address - Country:US
Mailing Address - Phone:740-605-0436
Mailing Address - Fax:
Practice Address - Street 1:2944 TOWNSHIP ROAD 186 SW
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OH
Practice Address - Zip Code:43748-9746
Practice Address - Country:US
Practice Address - Phone:740-605-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHVB313722374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide