Provider Demographics
NPI:1265524813
Name:NEWBY, JAMES EDWARD II (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:NEWBY
Suffix:II
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 1:930 MAJESTIC AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504
Mailing Address - Country:US
Mailing Address - Phone:757-627-6892
Mailing Address - Fax:757-627-5809
Practice Address - Street 1:930 MAJESTIC AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504
Practice Address - Country:US
Practice Address - Phone:757-627-6892
Practice Address - Fax:757-627-5809
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036297207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAA103561OtherFNP PRIMARY CARE-INDIVIDUAL PTAN
VA5657300Medicaid
VA098411OtherBLUE CROSS BLUS SHIELD
VAB07640Medicare UPIN
VA5657300Medicaid