Provider Demographics
NPI:1457158172
Name:NEWMAN, TIA
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12030 LITTLE PATUXENT PKWY
Mailing Address - Street 2:#G
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4816
Mailing Address - Country:US
Mailing Address - Phone:202-644-8479
Mailing Address - Fax:
Practice Address - Street 1:12030 LITTLE PATUXENT PKWY
Practice Address - Street 2:#G
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-4816
Practice Address - Country:US
Practice Address - Phone:202-644-8479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator