MEDICARE: VIVIEN R. NEWBOLD M.D.

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	208D00000X	General Practice Physician	35.064455	OH
2	207P00000X	Emergency Medicine Physician	35-06-4455	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	930008466	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	000000007422	OTHER	ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	001714081	OTHER	MOUNTAIN STATE BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326095290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIEN R. NEWBOLD M.D.

Provider Business Mailing Address
First Line	:	8170 CORPORATE PARK DR
Second Line	:	SUITE 150
City	:	CINCINNATI
State	:	OH
Zip	:	45242-3313
Country	:	US
Telephone Number	:	513-924-5300
Fax Number	:	513-351-3800

Provider Business Practice Location Address
First Line	:	8170 CORPORATE PARK DR
Second Line	:	SUITE 150
City	:	CINCINNATI
State	:	OH
Zip	:	45242-3313
Country	:	US
Telephone Number	:	513-924-5300
Fax Number	:	513-351-3800

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	11/17/2017

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Directions to “ VIVIEN R. NEWBOLD M.D.” Practice Location

Language	Start Address	Practice Location

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