Provider Demographics
NPI:1477621902
Name:HUANG, MARY ANN YI-ANG (MD)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:YI-ANG
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY ANN
Other - Middle Name:HUANG
Other - Last Name:SHERBONDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9403 CROWN CREST BLVD STE 420
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-9049
Mailing Address - Country:US
Mailing Address - Phone:303-925-4720
Mailing Address - Fax:303-925-4721
Practice Address - Street 1:9403 CROWN CREST BLVD STE 420
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-9049
Practice Address - Country:US
Practice Address - Phone:303-925-4720
Practice Address - Fax:303-925-4721
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076336207R00000X
CODR.0056376207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS076336OtherCHAMPUS-CHAMPUS
100H264400OtherBLUE CROSS-BLUE CROSS
MS076336OtherCOMMERCIAL-COMMERCIAL NUMBER
MI472437710Medicaid
CO56880065Medicaid
MS076336OtherCOMMERCIAL-COMMERCIAL NUMBER
0H26440048Medicare ID - Type Unspecified