Healthcare Provider Details

I. General information

NPI: 1114149085
Provider Name (Legal Business Name): MICHAEL DAVID NEWTON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12902 MAGNOLIA DRIVE
TAMPA FL
33612
US

IV. Provider business mailing address

1124 HEALTH SCIENCES CENTER NORTH BOX 9520
MORGANTOWN WV
26506
US

V. Phone/Fax

Practice location:
  • Phone: 813-745-6577
  • Fax:
Mailing address:
  • Phone: 304-293-8170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPS 35312
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: