MEDICARE: DR. MODEL N/A NEWAY M.D.

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	038570	GA
2	207R00000X	Internal Medicine Physician	038570	GA

General Provider Information

NPI Number	:	1598851636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MODEL N/A NEWAY M.D.

Provider Business Mailing Address
First Line	:	3112 PINE HEIGHTS DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-2843
Country	:	US
Telephone Number	:	404-812-9941
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 PINE HEIGHTS DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-2843
Country	:	US
Telephone Number	:	404-812-9941
Fax Number	:	404-812-9942

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	09/11/2025

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