Provider Demographics
NPI:1396733291
Name:LI, HUAMIN HENRY (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:HUAMIN
Middle Name:HENRY
Last Name:LI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11002 VEIRS MILL RD
Mailing Address - Street 2:414
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2574
Mailing Address - Country:US
Mailing Address - Phone:301-962-5800
Mailing Address - Fax:301-962-9585
Practice Address - Street 1:11002 VEIRS MILL RD
Practice Address - Street 2:SUITE 414
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2521
Practice Address - Country:US
Practice Address - Phone:301-962-5800
Practice Address - Fax:301-962-9585
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD55098207KA0200X
DCMD34049207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD675418OtherNCPPO
MD7657502OtherAETNA
MD02-00484OtherUNITED HEALTHCARE
MDC4540006OtherCAREFIRST NCA
MD233488OtherKAISER
MD2133588OtherMAMSI
MD675418OtherNCPPO
MD233488OtherKAISER
MD011976I81Medicare PIN