Healthcare Provider Details

I. General information

NPI: 1831151968
Provider Name (Legal Business Name): CARBER C HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 NE 139TH ST
VANCOUVER WA
98686-2300
US

IV. Provider business mailing address

2101 NE 139TH ST
VANCOUVER WA
98686-2300
US

V. Phone/Fax

Practice location:
  • Phone: 360-487-2800
  • Fax: 360-487-2809
Mailing address:
  • Phone: 360-487-2800
  • Fax: 360-487-2809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD00045284
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: