Individual
DEREK S. NEWSOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3200 MACCORKLE AVE SE, SUITE B16, CHARLESTON, WV 25304-1227
(304) 388-5848
(304) 388-9654
Mailing address
3200 MACCORKLE SEAVE B16, CHARLESTON, WV 25304-1227
(304) 388-5848
(303) 488-9654
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
01510
WV
Other
Enumeration date
09/23/2010
Last updated
12/23/2015
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