Provider Demographics
NPI:1538470976
Name:HORWICH, MICHAEL D (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:HORWICH
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:3455 MAIN ST STE 5
Mailing Address - Street 2:NEW ENGLAND DERMATOLOGY & LASER CENTER
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1147
Mailing Address - Country:US
Mailing Address - Phone:413-733-9600
Mailing Address - Fax:413-732-6534
Practice Address - Street 1:3455 MAIN ST STE 5
Practice Address - Street 2:NEW ENGLAND DERMATOLOGY & LASER CENTER
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1147
Practice Address - Country:US
Practice Address - Phone:413-733-9600
Practice Address - Fax:413-732-6534
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA258156207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology