Healthcare Provider Details

I. General information

NPI: 1679736128
Provider Name (Legal Business Name): ANDREW DWIGHT NEWBURN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2008
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 OXFORD ST STE 310
DOVER OH
44622-1966
US

IV. Provider business mailing address

340 OXFORD ST STE 310
DOVER OH
44622-1966
US

V. Phone/Fax

Practice location:
  • Phone: 330-364-8011
  • Fax: 330-364-0058
Mailing address:
  • Phone: 330-364-8011
  • Fax: 330-364-0058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.096523
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: