Provider Demographics
NPI:1396735007
Name:MOREHOUSE, WILLIAM RAYMOND (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RAYMOND
Last Name:MOREHOUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 ARNETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1147
Mailing Address - Country:US
Mailing Address - Phone:585-235-2250
Mailing Address - Fax:585-235-0011
Practice Address - Street 1:340 ARNETT BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1147
Practice Address - Country:US
Practice Address - Phone:585-235-2250
Practice Address - Fax:585-235-0011
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7700126OtherUNITED HEALTH CARE
NY000587556004OtherHEALTHY NY
NY00480240Medicaid
NY100666BFOtherPREFERRED CARE
NY3853OtherBC/BS OF ROCHESTER
NY5058322OtherAETNA
NY00480240Medicaid
13853BMedicare ID - Type Unspecified