Healthcare Provider Details

I. General information

NPI: 1952020711
Provider Name (Legal Business Name): MICHAEL DEE HUANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 04/30/2023
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 PEACHTREE INDUSTRIAL BLVD
SUWANEE GA
30024-6737
US

IV. Provider business mailing address

1000 PEACHTREE INDUSTRIAL BLVD
SUWANEE GA
30024-6737
US

V. Phone/Fax

Practice location:
  • Phone: 770-932-4306
  • Fax:
Mailing address:
  • Phone: 770-932-4306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH033892
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: