Healthcare Provider Details
I. General information
NPI: 1063444859
Provider Name (Legal Business Name): JEFFREY D. HOROWITZ, M.D., L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2006
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2225 OLD EMMORTON RD SUITE 111
BEL AIR MD
21015-6129
US
IV. Provider business mailing address
10845 PHILADELPHIA RD
WHITE MARSH MD
21162-1717
US
V. Phone/Fax
- Phone: 410-741-3440
- Fax:
- Phone: 410-335-0008
- Fax: 410-335-1133
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0122X |
| Taxonomy | Plastic and Reconstructive Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
D.
HOROWITZ
Title or Position: PRESIDENT
Credential:
Phone: 410-741-3440