Healthcare Provider Details

I. General information

NPI: 1124225511
Provider Name (Legal Business Name): ROBERT D NEWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3367 BUFORD HWY NE SUITE 910
ATLANTA GA
30329-1709
US

IV. Provider business mailing address

346 OAKDALE RD NE
ATLANTA GA
30307-2070
US

V. Phone/Fax

Practice location:
  • Phone: 404-880-3711
  • Fax:
Mailing address:
  • Phone: 404-222-0306
  • Fax: 770-488-4206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number048683
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: