Provider Demographics
NPI:1669764221
Name:NEWMAN, MICHAEL ALAN (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
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:ONE VETERANS DRIVE (111-0)
Mailing Address - Street 2:MINNEAPOLIS VETERANS AFFAIRS MEDICAL CENTER
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417
Mailing Address - Country:US
Mailing Address - Phone:612-467-2158
Mailing Address - Fax:
Practice Address - Street 1:ONE VETERANS DRIVE (111-0)
Practice Address - Street 2:MINNEAPOLIS VETERANS AFFAIRS MEDICAL CENTER
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417
Practice Address - Country:US
Practice Address - Phone:612-467-2158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN58138207R00000X
MN23801207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine