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NPI Code Detail

MEDICARE: MICHELLE NEWSOME PT

MEDICARE: MICHELLE NEWSOME PT
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
1225100000XPhysical Therapist05001097AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215054333
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE NEWSOME PT
Provider Business Mailing Address
First Line : 5068 ROBINSROCK WAY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-4009
Country : US
Telephone Number : 317-466-1000
Fax Number : 317-466-2000
Provider Business Practice Location Address
First Line : 5068 ROBINSROCK WAY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-4009
Country : US
Telephone Number : 317-250-8896
Fax Number : 317-466-2000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 03/25/2014

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Directions to “ MICHELLE NEWSOME PT” Practice Location

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