Healthcare Provider Details

I. General information

NPI: 1497861157
Provider Name (Legal Business Name): CAROL ANNE NEWMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. CAROL ANNE GILSON

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 W DUNLAP AVE STE. 290
PHOENIX AZ
85021-2737
US

IV. Provider business mailing address

2510 W DUNLAP AVE STE. 290
PHOENIX AZ
85021-2737
US

V. Phone/Fax

Practice location:
  • Phone: 602-789-0344
  • Fax: 602-870-7566
Mailing address:
  • Phone: 602-789-0344
  • Fax: 602-870-7566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCN082749
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL4078
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number49403
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: