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General NPI Number Information
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NPI Number | 1891502134
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Entity Type | Organization
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Legal Business Name | AUSTIN NEWSOME DERMATOLOGY CONSULTANT, PLLC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 101 ROLESVILLE CENTER RD STE 125
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City | ROLESVILLE
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State | NC
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Zip | 27571-7409
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Country | US
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Telephone | 919-205-4473
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 CRESCENT SQUARE ST
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City | RALEIGH
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State | NC
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Zip | 27616-4337
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Country | US
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Telephone | 757-927-0772
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUSTIN NEWSOME
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Credential | MD
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Telephone | 757-927-0772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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