Healthcare Provider Details

I. General information

NPI: 1659349439
Provider Name (Legal Business Name): CECIL HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44045 RIVERSIDE PKWY
LEESBURG VA
20176-5101
US

IV. Provider business mailing address

1544 SPRING HILL RD UNIT 10542
MC LEAN VA
22102-0129
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-6000
  • Fax: 571-209-6465
Mailing address:
  • Phone: 703-774-8991
  • Fax: 703-345-9372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101238687
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: