Individual
MR. STEPHEN MICHAEL NEWBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 S KEENE ST, COLUMBIA, MO 65201-7199
(816) 835-3004
Mailing address
1 S KEENE ST, COLUMBIA, MO 65201-7199
(816) 835-3004
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2017032699
MO
2255A2300X
Athletic Trainer
24-01245
KS
363A00000X
Physician Assistant
Primary
2024006431
MO
Other
Enumeration date
09/19/2017
Last updated
02/27/2024
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