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NPI Code Detail

MEDICARE: DR. SHANE NORMAN NEWBERGER M.D.

MEDICARE:  DR. SHANE NORMAN NEWBERGER  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
12085R0202XDiagnostic Radiology Physician4301101453MI

General Provider Information

NPI Number : 1700134731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANE NORMAN NEWBERGER M.D.
Provider Business Mailing Address
First Line : 3597 GRIFFITH AVE
Second Line :
City : BERKLEY
State : MI
Zip : 48072-1488
Country : US
Telephone Number : 248-535-4146
Fax Number :
Provider Business Practice Location Address
First Line : 3597 GRIFFITH AVE
Second Line :
City : BERKLEY
State : MI
Zip : 48072-1488
Country : US
Telephone Number : 248-535-4146
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2012
Last Update Date : 04/14/2026

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Directions to “ DR. SHANE NORMAN NEWBERGER M.D.” Practice Location

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