Healthcare Provider Details

I. General information

NPI: 1194782243
Provider Name (Legal Business Name): JOHN M HUFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 UNIVERSITY BLVD SUITE 104
WHEATON MD
20902-1979
US

IV. Provider business mailing address

804 SCOTT NIXON MEMORIAL DRIVE
AUGUSTA GA
30907-2464
US

V. Phone/Fax

Practice location:
  • Phone: 301-942-8799
  • Fax: 301-933-8554
Mailing address:
  • Phone: 800-394-4445
  • Fax: 706-650-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine
License NumberD51904
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine
License NumberD51904
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology
License NumberD51904
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: