Healthcare Provider Details

I. General information

NPI: 1710132444
Provider Name (Legal Business Name): GLORIA HUANG LEWIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GLORIA SCHU-CHING HUANG M.D.

II. Dates (important events)

Enumeration Date: 11/21/2008
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-3902
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-1149
US

V. Phone/Fax

Practice location:
  • Phone: 216-339-4069
  • Fax:
Mailing address:
  • Phone: 216-339-4069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number35.142264
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberR1571
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: