Healthcare Provider Details

I. General information

NPI: 1619890407
Provider Name (Legal Business Name): ANDREW HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FY RD NE
SANDY SPRINGS GA
30342-1606
US

IV. Provider business mailing address

1112 TREES OF KENNESAW PKWY NW # 1112
KENNESAW GA
30152-7653
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-8000
  • Fax:
Mailing address:
  • Phone: 786-329-0868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Q00000X
TaxonomyPathology Specialist/Technologist
License Number3432
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: