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General NPI Number Information
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NPI Number | 1689617797
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Entity Type | Individual
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Provider Name | DIANE R NEWTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 2035 SILVERCREEK LN
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City | BOISE
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State | ID
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Zip | 83706-6112
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Country | US
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Telephone | 208-368-0095
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Fax |
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Provider Business Mailing Address
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Address Line | 23625 COMMERCE PARK #204
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City | BEACHWOOD
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State | OH
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Zip | 44122-5845
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Country | US
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Telephone | 216-255-5743
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Fax | 866-735-3451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M7278
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | M7278
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License Number State | ID
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