Provider Demographics
NPI:1740349794
Name:HOUSE, WILLIAM COLUMBUS (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:COLUMBUS
Last Name:HOUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1341 ORANGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789
Mailing Address - Country:US
Mailing Address - Phone:407-629-7577
Mailing Address - Fax:407-629-1157
Practice Address - Street 1:1341 ORANGE AVENUE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789
Practice Address - Country:US
Practice Address - Phone:407-629-7577
Practice Address - Fax:407-629-1157
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34623207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA110221925OtherMEDICARE RAILROAD
FL47330OtherBLUE CROSS BLUE SHIELD
FL47330ZMedicare PIN