Healthcare Provider Details

I. General information

NPI: 1548453038
Provider Name (Legal Business Name): ALEX HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALEX HUANG

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVENUE
CLEVELAND OH
44106
US

IV. Provider business mailing address

24701 EUCLID AVE 3RD FLOOR
EUCLID OH
44117-1714
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-7700
  • Fax: 216-286-6341
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number90228
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberD0057464
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number35090228
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: