Healthcare Provider Details

I. General information

NPI: 1013302579
Provider Name (Legal Business Name): MATTHEW SHY-SZUAN HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 TAYLOR AVE STE 3002
COLUMBUS OH
43203-1278
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-688-6540
  • Fax: 614-688-6541
Mailing address:
  • Phone: 614-688-6540
  • Fax: 614-688-6541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.138769
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35.138769
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: