Healthcare Provider Details

I. General information

NPI: 1720109986
Provider Name (Legal Business Name): GRAHAM JOHN NEWSTEAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TOLLGATE ROAD SUITE 204
WARWICK RI
02886-4448
US

IV. Provider business mailing address

300 TOLLGATE ROAD SUITE 204
WARWICK RI
02886-4448
US

V. Phone/Fax

Practice location:
  • Phone: 401-738-2400
  • Fax: 401-732-8953
Mailing address:
  • Phone: 401-738-2400
  • Fax: 401-732-8953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD04236
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD04236
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: