Healthcare Provider Details

I. General information

NPI: 1902106040
Provider Name (Legal Business Name): GRACE A. NEWTON, M.D., DERMATOLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 TATE SPRINGS RD
LYNCHBURG VA
24501-1111
US

IV. Provider business mailing address

2007 TATE SPRINGS RD
LYNCHBURG VA
24501-1111
US

V. Phone/Fax

Practice location:
  • Phone: 434-947-5321
  • Fax:
Mailing address:
  • Phone: 434-947-5321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GRACE A. NEWTON
Title or Position: OWNER
Credential: M.D.
Phone: 434-947-5321