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Individual

DENNIS E NEWLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4131
(304) 485-3300
(304) 485-3317
Mailing address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4131
(304) 485-3300
(304) 485-3317

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15555
WV
207Q00000X
Family Medicine Physician
35.057511
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0042551000
WV
01
080150817
WV RAILROAD MEDICARE
WV
05
0815149
OH
01
P00368910
RAILROAD MEDICARE PIN
OH
Enumeration date
05/24/2005
Last updated
03/31/2011
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