Healthcare Provider Details

I. General information

NPI: 1619926342
Provider Name (Legal Business Name): ROBERT WILLIAM NEWELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 SPAULDING LAKE DR
GREENVILLE SC
29615-6036
US

IV. Provider business mailing address

518 SPAULDING LAKE DR
GREENVILLE SC
29615-6036
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number32156
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number11787
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: