Provider Demographics
NPI:1316949068
Name:HORI, MIKI (DPM)
Entity type:Individual
Prefix:
First Name:MIKI
Middle Name:
Last Name:HORI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1314
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1314
Mailing Address - Country:US
Mailing Address - Phone:540-434-2949
Mailing Address - Fax:540-433-8870
Practice Address - Street 1:2105 EVELYN BYRD AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5431
Practice Address - Country:US
Practice Address - Phone:540-434-2949
Practice Address - Fax:540-433-8870
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300821213E00000X, 213EP0504X, 213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X
VA1316949068213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1003914698OtherGROUP NPI
VA009302778Medicaid
VA1316949068OtherNPI
VA1316949068OtherNPI
VA480000704Medicare PIN
VA009302778Medicaid