Healthcare Provider Details

I. General information

NPI: 1437128261
Provider Name (Legal Business Name): YINNAN HWANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 WATER PLANT RD.
ZEBULON NC
27597-0425
US

IV. Provider business mailing address

P.O. BOX 425 1303 WATER PLANT RD.
ZEBULON NC
27597-0425
US

V. Phone/Fax

Practice location:
  • Phone: 919-269-4101
  • Fax: 919-269-8811
Mailing address:
  • Phone: 919-269-4101
  • Fax: 919-269-8811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number28653
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: