MEDICARE: DR. WILLIAM MARCUS NEWBERRY JR. 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	207RB0002X	Obesity Medicine (Internal Medicine) Physician	6318	SC

General Provider Information

NPI Number	:	1710276167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM MARCUS NEWBERRY JR. M.D.

Provider Business Mailing Address
First Line	:	2082 WOODRUFF RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-5992
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2082 WOODRUFF RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-5992
Country	:	US
Telephone Number	:	864-254-9930
Fax Number	:

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

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	04/06/2011

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