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Individual

JON A NEWSOME

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Mailing address
11781 LEE JACKSON MEMORIAL HWY, SUITE 550, FAIRFAX, VA 22033-3309
(571) 777-5157
(703) 890-2650

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D36756
MD
207L00000X
Anesthesiology Physician
MD035939
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010261970
VA
01
103042
KAISER
DC
01
1249925
AETNA HMO
DC
01
196304
ANTHEM BCBS
VA
05
297671403
MD
01
4273545
AETNA NON HMO
DC
01
496357
NCPPO
DC
Enumeration date
07/19/2006
Last updated
09/03/2015
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