Healthcare Provider Details
I. General information
NPI: 1598781395
Provider Name (Legal Business Name): SUBER S HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2006
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1611 S GREEN RD STE 230
CLEVELAND OH
44121-4134
US
IV. Provider business mailing address
1611 S GREEN RD STE 230
CLEVELAND OH
44121-4134
US
V. Phone/Fax
- Phone: 216-381-3366
- Fax: 216-382-4959
- Phone: 216-382-3366
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 35-060299 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | ME130276 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | 35-060299 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: