Provider Demographics
NPI:1275069817
Name:HUANG, BEVERLY A
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:A
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 1:1250 E. MARSHALL ST
Mailing Address - Street 2:BOX 980251
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298
Mailing Address - Country:US
Mailing Address - Phone:804-828-9626
Mailing Address - Fax:804-828-5856
Practice Address - Street 1:1250 E. MARSHALL ST
Practice Address - Street 2:BOX 980251
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298
Practice Address - Country:US
Practice Address - Phone:804-828-9626
Practice Address - Fax:804-828-5856
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101266557207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine