MEDICARE: DAVID MICHAEL NEWIRTH N.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	175F00000X	Naturopath	38	AK

General Provider Information

NPI Number	:	1750506655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MICHAEL NEWIRTH N.D.

Provider Business Mailing Address
First Line	:	5616 COPE ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99518-1511
Country	:	US
Telephone Number	:	907-258-2612
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 E NORTHERN LIGHTS BLVD STE C
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4219
Country	:	US
Telephone Number	:	907-349-3054
Fax Number	:	907-349-3056

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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