Provider Demographics
NPI:1194767095
Name:NEWMARK, HOWARD
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:NEWMARK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11203 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:KY
Mailing Address - Zip Code:41649-0910
Mailing Address - Country:US
Mailing Address - Phone:606-285-6400
Mailing Address - Fax:606-285-6629
Practice Address - Street 1:11203 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:KY
Practice Address - Zip Code:41649-0910
Practice Address - Country:US
Practice Address - Phone:606-285-6400
Practice Address - Fax:606-285-6629
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19073207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8577Medicare PIN
KY5490Medicare PIN
KY0549107Medicare UPIN
KY3331059Medicare PIN
KY5491Medicare PIN
KY0549027Medicare PIN