Healthcare Provider Details

I. General information

NPI: 1881643377
Provider Name (Legal Business Name): WILLIAM PETER NEWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 ELM ST N
FARGO ND
58102-2416
US

IV. Provider business mailing address

1919 ELM ST N
FARGO ND
58102-2416
US

V. Phone/Fax

Practice location:
  • Phone: 701-293-4133
  • Fax: 701-293-4145
Mailing address:
  • Phone: 701-293-4133
  • Fax: 701-293-4145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number4561
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number23611
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: