Provider Demographics
NPI:1598179269
Name:HOUSEPIAN, COREY (DPM)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:HOUSEPIAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 836 BOX 2670
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09636-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 836 BOX 2670
Practice Address - Street 2:USNMRTC SIGONELLA
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09636
Practice Address - Country:IT
Practice Address - Phone:314-624-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAEL6677213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist