Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 68191 | GA |
Y | 2080P0205X | Pediatric Endocrinologist | D79651 | MD |
NPI | 1407015407 |
---|---|
Provider Name | Dr. Paula Genese Newton |
First Address | Baltimore, MD 21264-2063 |
Second Address | Baltimore, MD 21201-4606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 22/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0116018426 | TRAINING LICENSE NUMBER (01) | VA |
651403100 | (05) | MD |