Healthcare Provider Details

I. General information

NPI: 1962498972
Provider Name (Legal Business Name): JOHNNY J HUH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 07/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 AFRICA RD STE 320
WESTERVILLE OH
43082
US

IV. Provider business mailing address

625 AFRICA RD STE 320
WESTERVILLE OH
43082-9808
US

V. Phone/Fax

Practice location:
  • Phone: 614-508-0110
  • Fax:
Mailing address:
  • Phone: 614-508-0110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number35-074136
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: