Individual
DIANE R NEWTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2035 SILVERCREEK LN, BOISE, ID 83706-6112
(208) 368-0095
Mailing address
23625 COMMERCE PARK, #204, BEACHWOOD, OH 44122-5845
(216) 255-5743
(866) 735-3451
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
M7278
ID
2085R0202X
Diagnostic Radiology Physician
Primary
M7278
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452114
—
LA
01
—
1689617797
TRICARE NORTH
—
05
—
223007100
—
MD
05
—
2914252
—
OH
05
—
804198300
—
ID
05
—
QM7278
—
SC
Enumeration date
06/14/2006
Last updated
02/15/2012
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