Basic Information
| Provider Information | |||||||||
| NPI: | 1205897808 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HORVICK | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2234 COLONIAL BLVD | ||||||||
| Address2: | ATTN: PAYER CONTRACTING & RELATIONS DEPT. | ||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339071412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399317342 | ||||||||
| FaxNumber: | 2399317385 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 SUNSET RD | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | WILLINGBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080461126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098773064 | ||||||||
| FaxNumber: | 6098772466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 09/30/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | MD030514E | PA | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | D0067927 | MD | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 25MA09102200 | NJ | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 001167823 0005 | 05 | PA | MEDICAID | 0011678230001 | 05 | PA | MEDICAID | 01228581 | 01 | MD | AMERIGROUP | OTHER | 3884504000 | 01 | NJ | AMERIHEALTH | OTHER | 6882-0006 | 01 | MD | CAREFIRST BCBS DC | OTHER | 88102701 (GREENBELT) | 01 | MD | CAREFIRST BCBS | OTHER | 940725-01 | 01 | MD | CAREFIRST BCBS | OTHER | 4339828 | 01 | MD | AETNA | OTHER | 50088876 | 01 | PA | CAPITOL BLUE CROSS | OTHER | 57573 | 01 | AETNA HEALTH PLAN | OTHER | 60101993 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 0091658000 | 01 | PA | PERSONAL CHOICE | OTHER | 01415563 | 01 | MD | AMERIGROUP (OMB) | OTHER | 0304034 | 05 | NJ | MEDICAID | 1096774 | 01 | NJ | CIGNA | OTHER | 4339828 | 01 | PA | AETNA PROVIDER # | OTHER | 0003 | 01 | DC | CAREFIRST BCBS | OTHER | 2671198 | 01 | NJ | GHI | OTHER | 94072503 (GETTYSBURG | 01 | MD | CAREFIRST BCBS | OTHER | 300016308 | 01 | RAILROAD MEDICARE | OTHER | 88102701 GREENBELT | 01 | MD | CAREFIRST BCBS | OTHER | 94072504 LITTLESTOWN | 01 | MD | CAREFIRST BCBS | OTHER | HO0000195426 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 1030965 | 01 | PA | KEYSTONE MERCY HEALTH PLA | OTHER | 195426 | 01 | PA | HIGHMARK BCBS | OTHER | P01055829 | 01 | NJ | RAILROAD MEDICARE | OTHER | 0002 | 01 | DC | CAREFIRST BCBS | OTHER | 0008 | 01 | DC | CAREFIRST BCBS | OTHER | 01666607 | 01 | NJ | AMERIGROUP | OTHER | 3603456 | 01 | MD | AMERICHOICE - BELCAMP OFFICE | OTHER | 4339828 | 01 | NJ | AETNA | OTHER | 94072506 | 01 | MD | CAREFIRST BCBS | OTHER | 1191658000 | 01 | PA | KEYSTONE HEALTH PLAN EAST | OTHER | 3603455 | 01 | MD | AMERICHOICE- BEL AIR OFFICE | OTHER | 415607200 | 05 | MD | MEDICAID | P00928691 | 01 | MD | RAILROAD MEDICARE (OMB) | OTHER |