Provider Demographics
NPI:1912016759
Name:HOWARD, DEWNZAR (MD)
Entity Type:Individual
Prefix:
First Name:DEWNZAR
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 GETTLER ST STE 405
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-2380
Mailing Address - Country:US
Mailing Address - Phone:219-440-7088
Mailing Address - Fax:219-440-7119
Practice Address - Street 1:2150 GETTLER ST STE 405
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-2380
Practice Address - Country:US
Practice Address - Phone:219-440-7088
Practice Address - Fax:219-440-7119
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010396342084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036075636Medicaid
IN100332070EMedicaid
IL036075636Medicaid
IN100332070EMedicaid