Healthcare Provider Details

I. General information

NPI: 1114411527
Provider Name (Legal Business Name): ANNE HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 05/29/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OLENTANGY RIVER RD
COLUMBUS OH
43212-3153
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8566
  • Fax:
Mailing address:
  • Phone: 614-293-8566
  • Fax: 614-293-3381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number125.072309
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35.150526
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: