Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 4301090826 | MI |
NPI | 1184897209 |
---|---|
Provider Name | Dr. Donnell Stephen Newman JR. |
First Address | Grosse Pointe Park, MI 48230-1016 |
Second Address | Grosse Pointe Park, MI 48230-1016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 09/04/2008 |