Individual
BRIAN NEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 W A ST STE G, MOSCOW, ID 83843-4902
(208) 883-1177
(208) 892-0170
Mailing address
PO BOX 8007, MOSCOW, ID 83843-0507
(208) 882-4511
(208) 883-6580
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M-15782
ID
208600000X
Surgery Physician
MT213453
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/29/2016
Last updated
09/01/2021
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