Provider Demographics
NPI:1902897101
Name:NEWTON, LEE CHRISTOPHER (OD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:CHRISTOPHER
Last Name:NEWTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 WILDER RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2126
Mailing Address - Country:US
Mailing Address - Phone:989-667-9393
Mailing Address - Fax:989-667-5577
Practice Address - Street 1:3720 WILDER RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2126
Practice Address - Country:US
Practice Address - Phone:989-667-9393
Practice Address - Fax:989-667-5577
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004072152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0989506OtherHEALTH PLUS OF MICHIGAN
MI900Z910400OtherBLUE CROSS BLUE SHIELD
MI944253433Medicaid
U82024Medicare UPIN
MI944253433Medicaid
MI900Z910400OtherBLUE CROSS BLUE SHIELD