Healthcare Provider Details

I. General information

NPI: 1801163712
Provider Name (Legal Business Name): NEWYOUHEALTHMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2011
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S MOORE RD SUITE B
CHATTANOOGA TN
37412-2987
US

IV. Provider business mailing address

400 S MOORE RD SUITE B
CHATTANOOGA TN
37412-2987
US

V. Phone/Fax

Practice location:
  • Phone: 423-894-4771
  • Fax: 423-894-9332
Mailing address:
  • Phone: 423-894-4771
  • Fax: 423-894-9332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14513
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9519
License Number StateTN

VIII. Authorized Official

Name: ROBERT DOBROWOLSKI
Title or Position: PRESIDENT
Credential:
Phone: 423-544-4448