MEDICARE: MARY JANE HOWARD MD

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	207RC0000X	Cardiovascular Disease Physician	01022313A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740256056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY JANE HOWARD MD

Provider Business Mailing Address
First Line	:	100 HOSPITAL LN
Second Line	:	STE.120
City	:	DANVILLE
State	:	IN
Zip	:	46122-1993
Country	:	US
Telephone Number	:	317-745-3830
Fax Number	:	317-745-3832

Provider Business Practice Location Address
First Line	:	100 HOSPITAL LN
Second Line	:	STE.120
City	:	DANVILLE
State	:	IN
Zip	:	46122-1993
Country	:	US
Telephone Number	:	317-745-3830
Fax Number	:	317-745-3832

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	07/16/2010

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