Provider Demographics
NPI:1659535706
Name:HORAN, MICHAEL PATRICK (MS, MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:HORAN
Suffix:
Gender:M
Credentials:MS, MD
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Mailing Address - Street 1:PO BOX 848932
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8932
Mailing Address - Country:US
Mailing Address - Phone:803-296-7303
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:14 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6877
Practice Address - Country:US
Practice Address - Phone:803-296-9200
Practice Address - Fax:803-296-9697
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2015-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SCTL33789207XP3100X
KYR1278207X00000X
NY257503-1207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC33789OtherLICENSE
SC337898Medicaid
SC33789OtherLICENSE