Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 14750 | KY |
Y | 207RN0300X | Nephrologist | 35-034576 | OH |
NPI | 1073557450 |
---|---|
Provider Name | Dr. Kenneth J Newmark |
First Address | Cincinnati, OH 45220-3027 |
Second Address | Cincinnati, OH 45220-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 02/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0258153 | (05) | OH |
64760465 | (05) | KY |
A74934 | (02) | OH |