Provider Demographics
NPI:1952362238
Name:NEWMAN, BENJAMIN G (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:G
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:729 SUMMER HARBOR ROAD
Mailing Address - Street 2:
Mailing Address - City:WINTER HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04693-0158
Mailing Address - Country:US
Mailing Address - Phone:207-963-2001
Mailing Address - Fax:888-719-5860
Practice Address - Street 1:729 SUMMER HARBOR ROAD
Practice Address - Street 2:
Practice Address - City:WINTER HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04693-0158
Practice Address - Country:US
Practice Address - Phone:207-963-2001
Practice Address - Fax:888-719-5860
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
VA0101239177207Q00000X
ME009232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171100000XOther Service ProvidersAcupuncturist