Provider Demographics
NPI:1033614110
Name:NEWSOME, MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:NEWSOME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9735 KINCEY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9120
Mailing Address - Country:US
Mailing Address - Phone:704-414-2865
Mailing Address - Fax:704-946-9216
Practice Address - Street 1:1780 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1194
Practice Address - Country:US
Practice Address - Phone:803-327-1116
Practice Address - Fax:803-327-6872
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2024-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC89650208800000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program