Healthcare Provider Details

I. General information

NPI: 1538201777
Provider Name (Legal Business Name): MARTIN H NEWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16620 N 40TH ST STE E-1
PHOENIX AZ
85032-3348
US

IV. Provider business mailing address

16430 N SCOTTSDALE RD STE 210
SCOTTSDALE AZ
85254-1581
US

V. Phone/Fax

Practice location:
  • Phone: 602-464-9576
  • Fax: 602-626-8901
Mailing address:
  • Phone: 602-464-9576
  • Fax: 602-626-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number36546
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: