Organization
TIDEWATER PAIN MANAGEMENT PC
Active
Other names
Mark W Newman DO
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WESLEY NEWMAN DO (PRESIDENT)
(757) 258-2561
Entity
Organization
Contact information
Practice address
4125 IRONBOUND ROAD, SUITE 101, WILLIAMSBURG, VA 23188-2631
(757) 258-2561
(757) 258-5936
Mailing address
4125 IRONBOUND ROAD, SUITE 101, WILLIAMSBURG, VA 23188-2631
(757) 258-2561
(757) 258-5936
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
0102037017
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
322590
ANTHEM BCBS
VA
Enumeration date
04/19/2006
Last updated
04/03/2008
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