Provider Demographics
NPI:1578667960
Name:HOROWITZ, ROBERT WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WAYNE
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:WAYNE
Other - Last Name:FELDBLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:230 NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1733
Mailing Address - Country:US
Mailing Address - Phone:712-252-0088
Mailing Address - Fax:712-252-5271
Practice Address - Street 1:230 NEBRASKA ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1733
Practice Address - Country:US
Practice Address - Phone:207-351-3777
Practice Address - Fax:207-351-3788
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014867207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME102100000Medicaid
G16588Medicare UPIN
MM7621Medicare ID - Type Unspecified
MEMM2289Medicare PIN