Provider Demographics
NPI:1548453038
Name:HUANG, ALEX (MD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-7700
Practice Address - Fax:216-286-6341
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH902282080P0207X
MDD00574642080P0207X
OH350902282080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2782609Medicaid
PA1021099250001OtherPA MEDICAID
OH000000226052OtherUNISON
OH000000538606OtherANTHEM
OH7016717OtherAETNA
OH421804OtherWELLCARE
OH751153OtherBUCKEYE
GA769816676AMedicaid
OH421804OtherWELLCARE