Provider Demographics
NPI:1205362993
Name:HWANG, BRICE (MD)
Entity Type:Individual
Prefix:
First Name:BRICE
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2897 N DRUID HILLS RD NE # 535
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3924
Mailing Address - Country:US
Mailing Address - Phone:470-795-6460
Mailing Address - Fax:762-257-6942
Practice Address - Street 1:1325 SATELLITE BLVD NW STE 208
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-5050
Practice Address - Country:US
Practice Address - Phone:470-795-6460
Practice Address - Fax:762-257-6942
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
GA95595207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program