MEDICARE: MRS. JULIE ELIZABETH NEWTON RDN/LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LD002310	GA

General Provider Information

NPI Number	:	1124532494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE ELIZABETH NEWTON RDN/LD

Provider Business Mailing Address
First Line	:	2688 LEE ANN DR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-3632
Country	:	US
Telephone Number	:	770-218-8105
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 ATLANTA HWY STE 1403
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-1277
Country	:	US
Telephone Number	:	678-722-1031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2017
Last Update Date	:	11/25/2017

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