Provider Demographics
NPI:1376644997
Name:MOREHOUSE, TODD C (DO)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:C
Last Name:MOREHOUSE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 WEST GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401
Mailing Address - Country:US
Mailing Address - Phone:610-279-1414
Mailing Address - Fax:610-279-4725
Practice Address - Street 1:60 WEST GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401
Practice Address - Country:US
Practice Address - Phone:610-279-1414
Practice Address - Fax:610-279-4725
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010682L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10130342700Medicaid
PA30025354OtherKEYSTONE MERCY
PA1725395OtherBLUE SHIELD OF PA
085751Medicare ID - Type Unspecified
PA10130342700Medicaid