Provider Demographics
NPI:1891726014
Name:HOROWITZ, JEFFREY D (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
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 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-1133
Practice Address - Street 1:2225 OLD EMMORTON RD
Practice Address - Street 2:SUITE 111
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6129
Practice Address - Country:US
Practice Address - Phone:410-741-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00607172086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11ZQJEOtherCAREFIRST
DC3794 0001OtherCAREFIRST
GADF0230OtherRAILROAD MEDICAE
GADF0230OtherRAILROAD MEDICAE
MDH96665Medicare UPIN