Individual
GREGORY MATTHEW NEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4205
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081009-022
BLUECROSS BLUESHIELD
OR
05
—
182506
—
OR
01
—
P00620265
MEDICARE RAILROAD
OR
Enumeration date
11/16/2005
Last updated
10/16/2008
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