Provider Demographics
NPI:1740256056
Name:HOWARD, MARY JANE (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:JANE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL LN
Mailing Address - Street 2:STE.120
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1993
Mailing Address - Country:US
Mailing Address - Phone:317-745-3830
Mailing Address - Fax:317-745-3832
Practice Address - Street 1:100 HOSPITAL LN
Practice Address - Street 2:STE.120
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1993
Practice Address - Country:US
Practice Address - Phone:317-745-3830
Practice Address - Fax:317-745-3832
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2010-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01022313A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100369830Medicaid
IN100369830Medicaid
INM400015037Medicare PIN
IN898190KKKKMedicare PIN