Basic Information
Provider Information
NPI: 1114121126
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEWMAN-CASEY
FirstName: PAULA
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NEWMAN
OtherFirstName: PAULA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3621 S STATE ST
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1000 WALL STREET
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481051912
CountryCode: US
TelephoneNumber: 7347644190
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/13/2007
LastUpdateDate: 05/20/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000X4301090005MIY Allopathic & Osteopathic PhysiciansOphthalmology 
390200000X4301090005MIN Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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