Provider Demographics
NPI:1336524800
Name:NEWELL, DONALD
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:NEWELL
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 1:6249 EAGLE RIDGE LN APT 102
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-6732
Mailing Address - Country:US
Mailing Address - Phone:810-339-5323
Mailing Address - Fax:
Practice Address - Street 1:6249 EAGLE RIDGE LN APT 102
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-6732
Practice Address - Country:US
Practice Address - Phone:810-339-5323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker