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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SHANE NEWSOM, 390200000X

Active Sole Proprietor

SHANE NEWSOM, 390200000X is a Contractor healthcare provider located in ALBUQUERQUE, New Mexico. NPI 1578184990 is currently active in the NPPES registry. Verify at CMS.

Contractor · ALBUQUERQUE, NM

Registration Details

NPI Number
1578184990
Provider Type
Individual
Gender
Male
NPI Issued
Apr 27, 2020 (6.3025220720912 yrs)
Last Updated
Apr 27, 2020
Sole Proprietor
Yes

Practice Information

Address
12300 MODESTO AVE NE
ALBUQUERQUE, NM, 871222232
Browse NM providers · Browse ZIP 87122
Phone
5055534835
Primary Specialty
Contractor
171W00000X

Other Contractor Providers in ALBUQUERQUE, NM

Name Credential NPI
MR. MARTIN D BINDER ATC 1104842525
RITA WORMWOOD 1891843264
CHERYL L KIRK-MCMULLEN OTR 1932234085
DONNA A KOTILAINEN P.T. 1538281720
MS. TAMARA ROSE MARTINEZ LMT 1013122290
KURT SIMMONS 1407062938
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.