Healthcare Provider Details

I. General information

NPI: 1639661705
Provider Name (Legal Business Name): MICHAEL K HUFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 HOOVER RD
GROVE CITY OH
43123-9122
US

IV. Provider business mailing address

1150 KINNEAR RD APT 1413A
COLUMBUS OH
43212-1171
US

V. Phone/Fax

Practice location:
  • Phone: 614-314-6118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: