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NPI Code Detail

MEDICARE: MR. SEAN M NEWBILL PA-C

MEDICARE: MR. SEAN M NEWBILL PA-C
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
1363A00000XPhysician Assistant50.002971OH

General Provider Information

NPI Number : 1245564137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SEAN M NEWBILL PA-C
Provider Business Mailing Address
First Line : P.O. BOX 40
Second Line :
City : PORT CLINTON
State : OH
Zip : 43452-0040
Country : US
Telephone Number : 419-732-1723
Fax Number : 419-734-0351
Provider Business Practice Location Address
First Line : 611 FULTON STREET
Second Line : SUITE C
City : PORT CLINTON
State : OH
Zip : 43452-2008
Country : US
Telephone Number : 419-732-6500
Fax Number : 419-732-1512
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2009
Last Update Date : 06/17/2011

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Directions to “ MR. SEAN M NEWBILL PA-C” Practice Location

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