Basic Information
Provider Information
NPI: 1851334080
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEWTON
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 GREEN RD
Address2: SUITE 300
City: ANN ARBOR
State: MI
PostalCode: 481051598
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5301 MCAULEY DR
Address2:  
City: YPSILANTI
State: MI
PostalCode: 481971051
CountryCode: US
TelephoneNumber: 7347123456
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/14/2006
LastUpdateDate: 06/05/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207PE0004X072815MIY Allopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services

ID Information
IDTypeStateIssuerDescription
440365705MI MEDICAID
485140405MI MEDICAID
CN07281501MIBC/BSOTHER


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