Provider Demographics
NPI:1992567036
Name:NEWMAN, CARLEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:CARLEIGH
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 ASHLEY AVE APT A
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-2102
Mailing Address - Country:US
Mailing Address - Phone:864-561-0614
Mailing Address - Fax:
Practice Address - Street 1:5401 NETHERBY LN STE 1202
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-7365
Practice Address - Country:US
Practice Address - Phone:843-872-3015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5188363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical