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NPI Code Detail

MEDICARE: ANGELA K HOUSE M.D.

MEDICARE:   ANGELA K HOUSE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician50411MN

General Provider Information

NPI Number : 1093980534
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA K HOUSE M.D.
Provider Business Mailing Address
First Line : 3429 39TH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2834
Country : US
Telephone Number : 651-238-9105
Fax Number :
Provider Business Practice Location Address
First Line : 2001 BLOOMINGTON AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-3074
Country : US
Telephone Number : 612-638-0700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2008
Last Update Date : 04/25/2008

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Directions to “ ANGELA K HOUSE M.D.” Practice Location

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