Provider Demographics
NPI:1720161540
Name:NEWMAN, WILLIAM ROY (DMIN)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROY
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MARKET SQ
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2497
Mailing Address - Country:US
Mailing Address - Phone:978-388-0022
Mailing Address - Fax:978-834-0990
Practice Address - Street 1:5 MARKET SQ
Practice Address - Street 2:SUITE 101
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2497
Practice Address - Country:US
Practice Address - Phone:978-388-0022
Practice Address - Fax:978-834-0990
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3484103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW03538OtherBLUE/BLUE SHIELD
MAR43351Medicare UPIN
MAW03538OtherBLUE/BLUE SHIELD