Provider Demographics
NPI:1659445351
Name:HORN, CAROLE ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:ELIZABETH
Last Name:HORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 19TH STREET NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3615
Mailing Address - Country:US
Mailing Address - Phone:202-296-0670
Mailing Address - Fax:202-331-8924
Practice Address - Street 1:1120 19TH STREET NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3615
Practice Address - Country:US
Practice Address - Phone:202-296-0670
Practice Address - Fax:202-331-8924
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD11853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C62404Medicare UPIN
0001L53541Medicare ID - Type Unspecified