Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MA27438 | NJ |
NPI | 1003803875 |
---|---|
Provider Name | Michael D Horn |
First Address | Willingboro, NJ 08046-2852 |
Second Address | Willingboro, NJ 08046-2852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 14/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0327603 | (05) | NJ |
D07034 | (02) |