Individual
DOUGLAS B HORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8153
Mailing address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8153
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
28242
WI
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
28242
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30798400
—
WI
Enumeration date
09/07/2005
Last updated
10/01/2020
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