Healthcare Provider Details

I. General information

NPI: 1750027124
Provider Name (Legal Business Name): JOHN MICHAEL NEWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 N NOVA RD STE 118
ORMOND BEACH FL
32174-4429
US

IV. Provider business mailing address

595 N NOVA RD STE 118
ORMOND BEACH FL
32174-4429
US

V. Phone/Fax

Practice location:
  • Phone: 386-675-6744
  • Fax:
Mailing address:
  • Phone: 386-675-6744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberME178976
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberME178976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: