Provider Demographics
NPI:1053609594
Name:NEWSTADT, JUSTIN PAUL (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:PAUL
Last Name:NEWSTADT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5916
Mailing Address - Country:US
Mailing Address - Phone:410-933-7600
Mailing Address - Fax:410-933-7601
Practice Address - Street 1:604 HOAGIE DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-1884
Practice Address - Country:US
Practice Address - Phone:410-893-4844
Practice Address - Fax:410-893-3927
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD81153208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics