Provider Demographics
NPI:1053613075
Name:HORIZON INTERNAL MEDICINE PLLC
Entity type:Organization
Organization Name:HORIZON INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-610-1300
Mailing Address - Street 1:138 DUBLIN SQUARE RD STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-8601
Mailing Address - Country:US
Mailing Address - Phone:336-824-2255
Mailing Address - Fax:336-824-8333
Practice Address - Street 1:1508 MAIN STREET
Practice Address - Street 2:
Practice Address - City:RAMSEUR
Practice Address - State:NC
Practice Address - Zip Code:27316-0218
Practice Address - Country:US
Practice Address - Phone:336-824-2255
Practice Address - Fax:336-824-8333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON INTERNAL MEDICINE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty