Provider Demographics
NPI:1750301610
Name:NEWMAN, HENRY A (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:A
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 W CAMARGO CT
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1921
Mailing Address - Country:US
Mailing Address - Phone:623-551-9944
Mailing Address - Fax:
Practice Address - Street 1:7725 N 43RD AVE
Practice Address - Street 2:SUITE 411
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-5770
Practice Address - Country:US
Practice Address - Phone:623-849-6122
Practice Address - Fax:623-848-6021
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5956174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5956OtherAZ LICENSE
AZ5956OtherAZ LICENSE
AZAN1270987OtherDEA NUMBER
AZ5956OtherAZ LICENSE