Provider Demographics
NPI:1356392195
Name:HOROWITZ, MARY M (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:M
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:NEOPLASTIC DISEASES/BONE MARROW TRANSPLANT
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-0700
Mailing Address - Fax:414-805-0714
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:NEOPLASTIC DISEASES/BONE MARROW TRANSPLANT
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-0700
Practice Address - Fax:414-805-0714
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-01-25
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Provider Licenses
StateLicense IDTaxonomies
WI24175207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1356392195Medicaid
002000120XOtherHUMANA
WI0821 73601Medicare PIN
002000120XOtherHUMANA