Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shane Newsom, 390200000X

Individual provider Contractor · NPI 1578184990

Shane Newsom, 390200000X is a Contractor in Albuquerque, New Mexico. Practices as a sole proprietor. Registered with an NPI since 2020.

In the registry since
2020
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Practice location Address checks out

12300 Modesto Ave NE
Albuquerque, NM 87122-2232
Phone: (505) 553-4835
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1578184990
Entity typeIndividual (Type 1)
GenderMale
Credentials 390200000X
Sole proprietorYes
NPI enumeratedApril 27, 2020
Last updated in NPPESApril 27, 2020
Certification dateApril 27, 2020

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