MEDICARE: RICHARD J HORBAL MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	4301039488	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	DG8718	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0E61134	OTHER	MI	BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1R00191	OTHER	MI	HEALTHPLUS OF MI
4	203484	OTHER	MI	MCLAREN HEALTH PLAN MI
5	0300900191	OTHER	MI	BCBSM
6	10505 30241	OTHER	MI	COMMUNITY CHOICE OF MI
7	101348	OTHER	MI	GREAT LAKES HEALTH PLAN
8	0300900191	OTHER	MI	BLUE CARE NETWORK

General Provider Information

NPI Number	:	1336228360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD J HORBAL MD PC

Provider Business Mailing Address
First Line	:	555 W WACKERLY ST
Second Line	:	SUITE 2675
City	:	MIDLAND
State	:	MI
Zip	:	48640-4722
Country	:	US
Telephone Number	:	989-631-1010
Fax Number	:	989-839-8800

Provider Business Practice Location Address
First Line	:	555 W WACKERLY ST
Second Line	:	SUITE 2675
City	:	MIDLAND
State	:	MI
Zip	:	48640-4722
Country	:	US
Telephone Number	:	989-631-1010
Fax Number	:	989-839-8800

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD J HORBAL
Credential	:	M.D.
Telephone Number	:	989-631-1010

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/23/2009

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Directions to “RICHARD J HORBAL MD PC ” Practice Location

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