Individual
DR. TRACIE TUGGLE NEWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2701 13TH AVE S, FARGO, ND 58103-3602
(701) 234-3620
Mailing address
2701 13TH AVE S, FARGO, ND 58103-3602
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12237
ND
208000000X
Pediatrics Physician
53118
MN
208000000X
Pediatrics Physician
54617-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16848
—
ND
05
—
1699967810
—
MN
05
—
1699967810
—
WI
Enumeration date
08/12/2007
Last updated
09/21/2012
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