MEDICARE: TAMARA J NEWELL M.S.

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	363L00000X	Nurse Practitioner	LD0000107	DE
2	363L00000X	Nurse Practitioner	AC000077	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740277615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA J NEWELL M.S.

Provider Business Mailing Address
First Line	:	4923 OGLETOWN STANTON RD
Second Line	:	SUITE 200
City	:	NEWARK
State	:	DE
Zip	:	19713-2081
Country	:	US
Telephone Number	:	302-225-0451
Fax Number	:	302-225-0472

Provider Business Practice Location Address
First Line	:	4923 OGLETOWN STANTON RD
Second Line	:	SUITE 200
City	:	NEWARK
State	:	DE
Zip	:	19713-2081
Country	:	US
Telephone Number	:	302-225-0451
Fax Number	:	302-225-0472

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	06/15/2011

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