Basic Information
Provider Information
NPI: 1063701902
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUANG
FirstName: SHUYAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7395 MACNICHOL LN
Address2:  
City: MANASSAS
State: VA
PostalCode: 201112918
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 9300 DEWITT LOOP
Address2:  
City: FORT BELVOIR
State: VA
PostalCode: 220605285
CountryCode: US
TelephoneNumber: 5712313224
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/31/2011
LastUpdateDate: 05/24/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X35.127514OHY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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