Provider Demographics
NPI:1477655249
Name:NEWBERGER, JUDITH (CNM)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:NEWBERGER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3319 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5103
Mailing Address - Country:US
Mailing Address - Phone:410-542-7800
Mailing Address - Fax:443-836-0405
Practice Address - Street 1:3319 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5103
Practice Address - Country:US
Practice Address - Phone:410-542-7800
Practice Address - Fax:443-836-0405
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR039359207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH856-K319Medicare ID - Type Unspecified