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General NPI Number Information
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NPI Number | 1992185011
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Entity Type | Individual
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Provider Name | MARCIA NICOLE NEWBY-GOODMAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | 930 MAJESTIC AVE STE 220
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City | NORFOLK
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State | VA
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Zip | 23504-4055
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Country | US
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Telephone | 757-942-8020
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Fax | 757-942-8015
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Provider Business Mailing Address
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Address Line | 930 MAJESTIC AVE STE 220
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City | NORFOLK
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State | VA
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Zip | 23504-4055
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Country | US
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Telephone | 757-942-8020
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Fax | 757-942-8015
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME129819
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21807
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 0101266602
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License Number State | VA
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