Healthcare Provider Details

I. General information

NPI: 1124181490
Provider Name (Legal Business Name): ALICE B. NEWELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOLBROOK ST
DANVILLE VA
24541-1732
US

IV. Provider business mailing address

101 HOLBROOK ST
DANVILLE VA
24541-1732
US

V. Phone/Fax

Practice location:
  • Phone: 434-792-7765
  • Fax: 434-793-4061
Mailing address:
  • Phone: 434-792-7765
  • Fax: 434-793-4061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101230123
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101230123
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: