Provider Demographics
NPI:1740505825
Name:HWANG, ANDREW (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 BOGAN MILL RD
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7343
Mailing Address - Country:US
Mailing Address - Phone:917-484-2054
Mailing Address - Fax:
Practice Address - Street 1:311 FULLER ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1514
Practice Address - Country:US
Practice Address - Phone:240-693-3281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND15464207Q00000X
ORMD187007207Q00000X
OK33674207Q00000X
IL036145932207Q00000X
MO2016031442207Q00000X
AZ56596207Q00000X
LA309387207Q00000X
NV17883207Q00000X
ALMD.36988207Q00000X
TXR9780207Q00000X
NE30826207Q00000X
SD10907207Q00000X
TN57400207Q00000X
CAC156047207Q00000X
KS0438970207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine