Provider Demographics
NPI:1871319095
Name:NEWPORT MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:NEWPORT MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:DUQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-847-9955
Mailing Address - Street 1:674 AQUIDNECK AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5795
Mailing Address - Country:US
Mailing Address - Phone:401-847-9955
Mailing Address - Fax:401-847-9948
Practice Address - Street 1:674 AQUIDNECK AVE STE 1
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5795
Practice Address - Country:US
Practice Address - Phone:401-847-9955
Practice Address - Fax:401-847-9948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty