Healthcare Provider Details

I. General information

NPI: 1689762429
Provider Name (Legal Business Name): MICHAEL H HORWITZ DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8637 DELMAR BLVD
SAINT LOUIS MO
63124-1906
US

IV. Provider business mailing address

8637 DELMAR BLVD
SAINT LOUIS MO
63124-1906
US

V. Phone/Fax

Practice location:
  • Phone: 314-983-0303
  • Fax: 314-983-2777
Mailing address:
  • Phone: 314-983-0303
  • Fax: 314-983-2777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number603
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: