Healthcare Provider Details

I. General information

NPI: 1639308232
Provider Name (Legal Business Name): XUAN HUANG M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41201 SCHADDEN RD STE 2
ELYRIA OH
44035-2249
US

IV. Provider business mailing address

PO BOX 749495
ATLANTA GA
30374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 440-324-0401
  • Fax: 440-324-0405
Mailing address:
  • Phone: 239-432-8331
  • Fax: 239-321-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35-099158
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number099158
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberD0069386
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD489481C
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: