Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0101260188 | VA |
Y | 207Q00000X | Family Doctor | D81412 | MD |
N | 207QS0010X | Family Doctor - Sports Medicine | 0101260188 | VA |
N | 207QS0010X | Family Doctor - Sports Medicine | D81412 | MD |
NPI | 1093986697 |
---|---|
Provider Name | Benjamin James Newton |
First Address | Hunt Valley, MD 21031 |
Second Address | Chevy Chase, MD 20815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2008 |
Last Update Date | 26/07/2021 |