Healthcare Provider Details

I. General information

NPI: 1730356775
Provider Name (Legal Business Name): DR. DEBORAH MARINCA HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH MARINCA MD

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST # AF-1016
AUGUSTA GA
30912-5812
US

IV. Provider business mailing address

1120 15TH ST # AF-1016
AUGUSTA GA
30912-0004
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2705
  • Fax: 706-721-9081
Mailing address:
  • Phone: 706-721-2705
  • Fax: 706-721-9081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number149365
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number72341
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: