Provider Demographics
NPI:1770529554
Name:NEWMAN, MARC C (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:C
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:3/208N
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-707-5522
Mailing Address - Fax:215-707-5031
Practice Address - Street 1:3322 N BROAD ST
Practice Address - Street 2:DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5185
Practice Address - Country:US
Practice Address - Phone:215-707-4600
Practice Address - Fax:215-707-4034
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2011-09-15
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Provider Licenses
StateLicense IDTaxonomies
PAMD051852L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001786465Medicaid
PA001786465Medicaid
PA513507Medicare ID - Type Unspecified