Healthcare Provider Details

I. General information

NPI: 1669415360
Provider Name (Legal Business Name): SHAUN SU HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 EAST MEDICAL CENTER DR B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY
ANN ARBOR MI
48109-5014
US

IV. Provider business mailing address

3621 S STATE ST 700 KMS PLACE
ANN ARBOR MI
48108
US

V. Phone/Fax

Practice location:
  • Phone: 734-936-6666
  • Fax:
Mailing address:
  • Phone: 734-936-2047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301064134
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: