Provider Demographics
NPI:1417175290
Name:HUANG, SHIRLEY A (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:A
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2594 TRAILRIDGE DR E
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3186
Mailing Address - Country:US
Mailing Address - Phone:303-449-7740
Mailing Address - Fax:303-605-5393
Practice Address - Street 1:2594 TRAILRIDGE DR E
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3186
Practice Address - Country:US
Practice Address - Phone:303-449-7740
Practice Address - Fax:303-605-5393
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47747207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine