Provider Demographics
NPI:1942008073
Name:NEWBY, DWIGHT IV (MD)
Entity type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:
Last Name:NEWBY
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:OWEN
Other - Middle Name:
Other - Last Name:LUWIS
Other - Suffix:IV
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1720 BRIGHTSEAT RD
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3777
Mailing Address - Country:US
Mailing Address - Phone:833-962-0481
Mailing Address - Fax:415-555-0132
Practice Address - Street 1:1720 BRIGHTSEAT RD
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-3777
Practice Address - Country:US
Practice Address - Phone:833-962-0481
Practice Address - Fax:415-555-0132
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103G004567A103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist