Provider Demographics
NPI:1457417172
Name:HUIE, MICHAEL ANDREW (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANDREW
Last Name:HUIE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 IRVING ST
Mailing Address - Street 2:STE 980
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2216
Mailing Address - Country:US
Mailing Address - Phone:650-712-1200
Mailing Address - Fax:866-425-2302
Practice Address - Street 1:585 KELLY AVE
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-1923
Practice Address - Country:US
Practice Address - Phone:650-712-1200
Practice Address - Fax:866-425-2302
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG81413207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G814132Medicare ID - Type Unspecified
G92450Medicare UPIN