Healthcare Provider Details

I. General information

NPI: 1104178813
Provider Name (Legal Business Name): ADAM M NEWMAN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 RUSH DR
SALIDA CO
81201-9627
US

IV. Provider business mailing address

UNIVERSITY OF NEW MEXICO HOSPITAL DEPARTMENT MSC 10 5610, 1 UNIVERSITY OF NEW MEXICO
ALBUQUERQUE NM
87131-0001
US

V. Phone/Fax

Practice location:
  • Phone: 719-530-2000
  • Fax: 719-539-5068
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA.0009685
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: