Healthcare Provider Details

I. General information

NPI: 1649665886
Provider Name (Legal Business Name): ERIK NEWMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2015
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N 1900 E
SALT LAKE CITY UT
84132-0002
US

IV. Provider business mailing address

13123 E 16TH AVE BOX 518
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-6465
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number10102300-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: