Provider Demographics
NPI:1821330663
Name:HOROWITZ, MICHAEL DORY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DORY
Last Name:HOROWITZ
Suffix:
Gender:M
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:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:GA
Mailing Address - Zip Code:30146-0639
Mailing Address - Country:US
Mailing Address - Phone:678-469-1154
Mailing Address - Fax:
Practice Address - Street 1:3465 HARLAN DR SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4617
Practice Address - Country:US
Practice Address - Phone:678-469-1154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA54431208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)