Healthcare Provider Details

I. General information

NPI: 1740812296
Provider Name (Legal Business Name): MEGAN NEWSOM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST
RICHMOND VA
23298-5023
US

IV. Provider business mailing address

1207 N 24TH ST
RICHMOND VA
23223-5232
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9000
  • Fax:
Mailing address:
  • Phone: 757-943-2407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number0116035104
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: