Provider Demographics
NPI:1144204371
Name:HUANG, ABBOTT BEN (MD)
Entity Type:Individual
Prefix:
First Name:ABBOTT
Middle Name:BEN
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NEW MEXICO AVE NW STE 106
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3622
Mailing Address - Country:US
Mailing Address - Phone:202-966-0606
Mailing Address - Fax:
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:SUITE 106
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3622
Practice Address - Country:US
Practice Address - Phone:202-966-0606
Practice Address - Fax:202-244-6757
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD300382085R0202X
MDD00507472085R0202X
VAO1010542302085R0202X
WAMD000439942085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD805050300Medicaid
470001526OtherRR MEDICARE
300135379OtherRR MEDICARE
MD784M364FMedicare PIN
DC00B424O31Medicare PIN
300135379OtherRR MEDICARE
MD805050300Medicaid
MD575P187HMedicare PIN
DC007446W30Medicare PIN