Healthcare Provider Details

I. General information

NPI: 1336651348
Provider Name (Legal Business Name): DANNIE HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 10/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 KAYEN CHANDO
DEDEDO GU
96929-5900
US

IV. Provider business mailing address

PO BOX 9764
TAMUNING GU
96931-5764
US

V. Phone/Fax

Practice location:
  • Phone: 671-922-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH0259
License Number StateGU
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26027139A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: