Provider Demographics
NPI:1912939281
Name:HOUSTON, BRIAN DELANEY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DELANEY
Last Name:HOUSTON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1199 VAN VOORHIS RD
Mailing Address - Street 2:STE 5
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-598-0110
Mailing Address - Fax:304-285-2771
Practice Address - Street 1:1199 VAN VOORHIS RD
Practice Address - Street 2:STE 5
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-598-0110
Practice Address - Fax:304-285-2771
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-11-27
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Provider Licenses
StateLicense IDTaxonomies
WV10461207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV55-0642031OtherTAX ID
WV0075667000Medicaid
WV55-0642031OtherTAX ID
A72043Medicare UPIN