Provider Demographics
NPI:1588227748
Name:HUANG, SHENWEN
Entity type:Individual
Prefix:
First Name:SHENWEN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 FAIRVIEW PARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-4578
Mailing Address - Country:US
Mailing Address - Phone:703-914-2942
Mailing Address - Fax:
Practice Address - Street 1:3130 FAIRVIEW PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-4578
Practice Address - Country:US
Practice Address - Phone:703-914-2942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD972462084N0400X
VA01012809822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology