Provider Demographics
NPI:1841306552
Name:NEWCOMB, DEVI M (MD)
Entity type:Individual
Prefix:
First Name:DEVI
Middle Name:M
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MTSU HEALTH SERVICES
Mailing Address - Street 2:P.O. BOX 237
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37132
Mailing Address - Country:US
Mailing Address - Phone:615-898-2988
Mailing Address - Fax:615-898-5004
Practice Address - Street 1:1301 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37132-0001
Practice Address - Country:US
Practice Address - Phone:615-898-2988
Practice Address - Fax:615-898-5004
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38323207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3718641Medicaid
TN3891397Medicaid
TN4083247OtherBCBSTN
TN3710089Medicaid
TN3891397Medicaid
TN3710089Medicare PIN
TN4083247OtherBCBSTN
TN3718641Medicaid
TNCE0561Medicare PIN
TN3718641Medicare PIN