Healthcare Provider Details

I. General information

NPI: 1720302276
Provider Name (Legal Business Name): GREGORY S HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 10/13/2023
Certification Date: 10/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 COVINGTON ST
YOUNGSTOWN OH
44510-1617
US

IV. Provider business mailing address

1001 COVINGTON ST
YOUNGSTOWN OH
44510-1617
US

V. Phone/Fax

Practice location:
  • Phone: 330-480-2371
  • Fax: 330-480-3970
Mailing address:
  • Phone: 330-480-2371
  • Fax: 330-480-3970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number35.096955
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: