Healthcare Provider Details

I. General information

NPI: 1144255340
Provider Name (Legal Business Name): DAVID HOANG M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 W CENTRAL AVE
DELAWARE OH
43015-1405
US

IV. Provider business mailing address

340 POLARIS PKWY
WESTERVILLE OH
43082-7971
US

V. Phone/Fax

Practice location:
  • Phone: 740-369-8751
  • Fax: 740-363-7265
Mailing address:
  • Phone: 614-545-7900
  • Fax: 614-545-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number35078858
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: