Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0101247116 | VA |
N | 207V00000X | Obstetrician & Gynecologist | 01059367A | IN |
N | 207V00000X | Obstetrician & Gynecologist | 37932 | AZ |
Y | 207VX0000X | Obstetrician | 2021014176 | MO |
NPI | 1154310688 |
---|---|
Provider Name | Dr. Adam T Newman |
First Address | Clinton, MO 64735-1192 |
Second Address | Clinton, MO 64735-1192 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 16/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000570089 | ANTHEM (01) | IN |
200171950 | (05) | IN |
37932 | AZ MEDICAL BOARD (01) | AZ |
385840 | (05) | AZ |
G48426 | (02) | IN |