Individual
MICHAEL G HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 N UNIVERSITY BLVD., SUITE 1295, INDIANAPOLIS, IN 46202-5149
(317) 944-8330
(317) 944-7648
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01065146A
IN
2086X0206X
Surgical Oncology Physician
01065146A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000577378
ANTHEM PIN
IN
05
—
200904160
—
IN
01
—
233690GGG
MEDICARE PTAN
IN
Enumeration date
04/22/2008
Last updated
02/13/2024
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