Provider Demographics
NPI:1710050562
Name:HOROWITZ, HOWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17000 SCIENCE DR
Mailing Address - Street 2:#104
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4420
Mailing Address - Country:US
Mailing Address - Phone:301-464-5900
Mailing Address - Fax:301-464-5901
Practice Address - Street 1:17000 SCIENCE DR
Practice Address - Street 2:#104
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4420
Practice Address - Country:US
Practice Address - Phone:301-464-5900
Practice Address - Fax:301-464-5901
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD920213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD479710Medicare PIN
MDT31264Medicare UPIN