MEDICARE: TONDRA MICHELLE NEWMAN 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	207V00000X	Obstetrics & Gynecology Physician	35.098845	OH
2	207VM0101X	Maternal & Fetal Medicine Physician	65393	AZ
3	207V00000X	Obstetrics & Gynecology Physician	87010	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922260611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONDRA MICHELLE NEWMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 14305
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-1305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 GLENLAKE PKWY
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-3473
Country	:	US
Telephone Number	:	770-677-5838
Fax Number	:

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

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	06/07/2024

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