Healthcare Provider Details

I. General information

NPI: 1699707588
Provider Name (Legal Business Name): ROBERT MICHAEL NEWMAN D. C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 W VLIET ST
MILWAUKEE WI
53208-2623
US

IV. Provider business mailing address

2171 N 64TH ST
WAUWATOSA WI
53213-2027
US

V. Phone/Fax

Practice location:
  • Phone: 414-727-3909
  • Fax: 414-727-3910
Mailing address:
  • Phone: 414-771-6159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1634012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: