Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 2016009340 | MO |
N | 2080P0216X | Pediatric Rheumatologist | 2016009340 | MO |
NPI | 1649613332 |
---|---|
Provider Name | Dr. Mara Harmelin Horwitz |
First Address | Saint Louis, MO 63104-1004 |
Second Address | Saint Louis, MO 63104-1016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2013 |
Last Update Date | 05/02/2021 |