Healthcare Provider Details

I. General information

NPI: 1821610569
Provider Name (Legal Business Name): MIYANTE YUKI NEWTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1590
US

IV. Provider business mailing address

110 S PACA ST 6 FL, SUITE 200
BALTIMORE MD
21201-1642
US

V. Phone/Fax

Practice location:
  • Phone: 667-214-2208
  • Fax: 410-328-8028
Mailing address:
  • Phone: 667-214-2208
  • Fax: 410-328-8028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD0104734
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0104734
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD0104734
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: