Healthcare Provider Details

I. General information

NPI: 1710312582
Provider Name (Legal Business Name): CAMERON HUH AP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3607 OLD NORCROSS RD SUITE A
DULUTH GA
30096-4613
US

IV. Provider business mailing address

3607 OLD NORCROSS RD SUITE A
DULUTH GA
30096-4613
US

V. Phone/Fax

Practice location:
  • Phone: 770-451-2999
  • Fax: 770-813-2219
Mailing address:
  • Phone: 770-451-2999
  • Fax: 770-813-2219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number298
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: