Healthcare Provider Details

I. General information

NPI: 1508865494
Provider Name (Legal Business Name): ELIZABETH A NEWMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH A SLITER M.D.

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 RODEO LN SUITE A-2
SANTA FE NM
87507-6400
US

IV. Provider business mailing address

3600 RODEO LN SUITE A-1
SANTA FE NM
87507-6400
US

V. Phone/Fax

Practice location:
  • Phone: 505-629-4400
  • Fax: 505-474-4277
Mailing address:
  • Phone: 505-474-6097
  • Fax: 505-471-4503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0427781
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: