MEDICARE: DR. DAREN MARK NEWFIELD 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	040750	GA

General Provider Information

NPI Number	:	1760591242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAREN MARK NEWFIELD M.D.

Provider Business Mailing Address
First Line	:	541-207 TENTH STREET NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-5713
Country	:	US
Telephone Number	:	404-845-0777
Fax Number	:	404-256-2443

Provider Business Practice Location Address
First Line	:	541 10TH ST NW
Second Line	:	BOX 207
City	:	ATLANTA
State	:	GA
Zip	:	30318-5713
Country	:	US
Telephone Number	:	404-845-0777
Fax Number	:	404-256-2443

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	12/10/2013

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