Provider Demographics
NPI:1174754204
Name:NEWTON, DAVID SIMON (OTR)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SIMON
Last Name:NEWTON
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 TANNER DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-4714
Mailing Address - Country:US
Mailing Address - Phone:248-680-7377
Mailing Address - Fax:
Practice Address - Street 1:496 TANNER DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-4714
Practice Address - Country:US
Practice Address - Phone:248-680-7377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility