Healthcare Provider Details

I. General information

NPI: 1730043332
Provider Name (Legal Business Name): JOSHUA ALLAN HOUSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 GREENWAY CT
SANFORD NC
27330-6954
US

IV. Provider business mailing address

1629 TEMPTING CHURCH RD
SANFORD NC
27330-6356
US

V. Phone/Fax

Practice location:
  • Phone: 919-708-1528
  • Fax:
Mailing address:
  • Phone: 919-356-0198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16910
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: