Provider Demographics
NPI:1497918635
Name:HORVATH, DAVID PAUL (IDC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:HORVATH
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3399 STRAUSS AVE STE 219
Mailing Address - Street 2:
Mailing Address - City:INDIAN HEAD
Mailing Address - State:MD
Mailing Address - Zip Code:20640-5164
Mailing Address - Country:US
Mailing Address - Phone:951-837-6995
Mailing Address - Fax:301-744-1028
Practice Address - Street 1:3399 STRAUSS AVE STE 219
Practice Address - Street 2:
Practice Address - City:INDIAN HEAD
Practice Address - State:MD
Practice Address - Zip Code:20640-5164
Practice Address - Country:US
Practice Address - Phone:951-837-6995
Practice Address - Fax:301-744-1028
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman