Healthcare Provider Details

I. General information

NPI: 1104824705
Provider Name (Legal Business Name): DAVID MICHAEL NEWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 BANK ST
BATAVIA NY
14020-2250
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-4800
  • Fax: 585-344-7369
Mailing address:
  • Phone: 585-922-1900
  • Fax: 585-922-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number152753
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: