Provider Demographics
NPI:1760479448
Name:HOROWITZ, JOEL I (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:I
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 64367
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-0367
Mailing Address - Country:US
Mailing Address - Phone:910-323-2626
Mailing Address - Fax:910-483-6376
Practice Address - Street 1:1841 QUIET CV
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3857
Practice Address - Country:US
Practice Address - Phone:910-323-2626
Practice Address - Fax:910-483-6376
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9500944208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC57640OtherMEDCOST
NC8943865Medicaid
NC020042692OtherRAIL ROAD MEDICARE
NC1738855OtherUNITEDHEALTH CARE
NC43865OtherBLUE CROSS BLUE SHIELD
NC8943865Medicaid
NC43865OtherBLUE CROSS BLUE SHIELD