Healthcare Provider Details

I. General information

NPI: 1285139014
Provider Name (Legal Business Name): MICHAEL WEIHAN HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2018
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

IV. Provider business mailing address

801 SPRUCE ST FL 6
PHILADELPHIA PA
19107-5701
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-4000
  • Fax:
Mailing address:
  • Phone: 267-428-7032
  • Fax: 636-336-1327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD471022
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: