IndividualActive
Derek Newsome, PA-C
NPI 1669780649 · Medical Physician Assistant · Charleston, WV
Provider details
- NPI number
- 1669780649
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 01510 (WV)
Practice location
3200 Maccorkle Ave Se
Suite B16
Charleston, WV 25304-1227
Phone: (304) 388-5848
Fax: (304) 388-9654
Mailing address
3200 Maccorkle Seave B16
Charleston, WV 25304-1227
Registry dates
- Enumerated
- 2010-09-23
- Last updated
- 2015-12-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.