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Individual
DAMON NEWSOME JR.
Active
Individual
DAMON NEWSOME JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
024870
NY
363AM0700X
Medical Physician Assistant
24870
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000524189
BCBS
KY
01
—
000559736001
BCBS HIGHMARK
NY
05
—
07268739
—
NY
05
—
95004933
—
KY
01
—
P00176973
RAILROAD
—
01
—
Q00328306
RAILROAD
NY
Enumeration date
01/10/2006
Last updated
09/18/2024
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