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General NPI Number Information
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NPI Number | 1306980602
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Entity Type | Individual
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Provider Name | THOMAS JOSEPH HORNYAK M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10 CENTER DR BUILDING 10, ROOM 12N242, MSC1908
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-451-1926
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Fax | 301-496-5370
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Provider Business Mailing Address
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Address Line | 5909 KINGSWOOD RD
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City | BETHESDA
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State | MD
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Zip | 20814-1821
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Country | US
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Telephone | 301-897-2992
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Fax | 301-897-2992
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4301073444
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License Number State | MI
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