Provider Demographics
NPI:1992803761
Name:HOWANITZ, E PAUL (MD)
Entity type:Individual
Prefix:
First Name:E
Middle Name:PAUL
Last Name:HOWANITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 REID PARKWAY
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-983-3427
Mailing Address - Fax:765-935-8739
Practice Address - Street 1:1100 REID PARKWAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1157
Practice Address - Country:US
Practice Address - Phone:765-983-3427
Practice Address - Fax:765-935-8739
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060276208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200512900Medicaid
IN000000358657OtherBLUE SHIELD - REID HOSP
OH0650540Medicaid
OH0650540Medicaid
INP00228848Medicare Oscar/Certification
IN940940NNNNMedicare Oscar/Certification