Healthcare Provider Details

I. General information

NPI: 1952535189
Provider Name (Legal Business Name): MR. STEVEN WAYNE NEWSOM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 W BAY DR
LARGO FL
33770-3221
US

IV. Provider business mailing address

215 SHUMAN BLVD STE 401
NAPERVILLE IL
60563-8123
US

V. Phone/Fax

Practice location:
  • Phone: 727-518-1111
  • Fax: 727-518-1110
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number02821
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number7479
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberO3-0000255
License Number StateDE
# 4
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS5466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: