Healthcare Provider Details

I. General information

NPI: 1063701902
Provider Name (Legal Business Name): SHUYAN HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

IV. Provider business mailing address

7395 MACNICHOL LN
MANASSAS VA
20111-2918
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-3224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.127514
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: