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Individual
DR. MARYJO A HOUSTON
Active
Individual
DR. MARYJO A HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD036534E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001123088
—
PA
01
—
080172837
RAILROAD MEDICARE
—
01
—
133764
BLUE SHIELD
—
01
—
205766
UPMC HEALTH PLAN
—
01
—
4070665
AETNA
—
01
—
P000250
GATEWAY HEALTH PLAN
—
Enumeration date
06/09/2006
Last updated
02/11/2020
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