MEDICARE: DR. CHRISTOPHER NEWELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101228183	VA

General Provider Information

NPI Number	:	1275954588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER NEWELL MD

Provider Business Mailing Address
First Line	:	PO BOX 710080
Second Line	:
City	:	HERNDON
State	:	VA
Zip	:	20171-0080
Country	:	US
Telephone Number	:	804-833-8795
Fax Number	:	703-802-4730

Provider Business Practice Location Address
First Line	:	11357 NUCKOLS RD
Second Line	:	# 163
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-5504
Country	:	US
Telephone Number	:	804-833-8795
Fax Number	:	703-802-4730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2014
Last Update Date	:	01/04/2014

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