Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1634012 | WI |
NPI | 1699707588 |
---|---|
Provider Name | Dr. Robert Michael Newman |
First Address | Wauwatosa, WI 53213-2027 |
Second Address | Milwaukee, WI 53208-2623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T62874 | (02) | WI |