Healthcare Provider Details

I. General information

NPI: 1235077116
Provider Name (Legal Business Name): MICHAEL HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MASSACHUSETTS AVE
BOSTON MA
02118-2605
US

IV. Provider business mailing address

801 MASSACHUSETTS AVE
BOSTON MA
02118-2605
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-4238
  • Fax:
Mailing address:
  • Phone: 617-414-4238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3020343
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: