Provider Demographics
NPI:1194716555
Name:NEWMAN, GEORGIA LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:LYNNE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:224 W LORAIN ST
Mailing Address - Street 2:STE A
Mailing Address - City:OBERLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44074-1096
Mailing Address - Country:US
Mailing Address - Phone:440-774-5248
Mailing Address - Fax:440-774-6006
Practice Address - Street 1:224 W LORAIN ST
Practice Address - Street 2:STE A
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-1096
Practice Address - Country:US
Practice Address - Phone:440-774-5248
Practice Address - Fax:440-774-6006
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.037158207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0249994Medicaid
OHNE0399775Medicare ID - Type Unspecified
OH0249994Medicaid