Provider Demographics
NPI:1851352025
Name:HOUSER, ARCHIBALD W (MD)
Entity Type:Individual
Prefix:
First Name:ARCHIBALD
Middle Name:W
Last Name:HOUSER
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 1:212 LINDEN DR
Mailing Address - Street 2:SUITE 152
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2894
Mailing Address - Country:US
Mailing Address - Phone:540-667-0744
Mailing Address - Fax:540-665-8158
Practice Address - Street 1:212 LINDEN DR
Practice Address - Street 2:SUITE 152
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2894
Practice Address - Country:US
Practice Address - Phone:540-667-0744
Practice Address - Fax:540-665-8158
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101226516207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5842921Medicaid
110209330OtherRAILROAD MEDICARE
110007736Medicare PIN
H17455Medicare UPIN
110209330Medicare ID - Type Unspecified