Individual
DR. CHARLES P HOUSE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
420 W MCPHERSON HWY, CLYDE, OH 43410-1133
(419) 547-0584
(419) 547-8918
Mailing address
PO BOX 179, BELLEVUE, OH 44811-0179
(440) 274-5000
(440) 716-8608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-007179
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000351615
ANTHEM
OH
01
—
04663
PARAMOUNT
OH
01
—
20711612
UNITED HEALTHCARE
OH
05
—
2158472
—
OH
01
—
58182
NATIONWIDE HEALTH PLAN
OH
01
—
P00180079
RAILROAD MEDICARE
OH
Enumeration date
03/15/2006
Last updated
11/23/2009
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