Provider Demographics
NPI:1730356775
Name:HUANG, DEBORAH MARINCA
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:MARINCA
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:MARINCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1120 15TH ST # AF-1016
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-721-2705
Mailing Address - Fax:706-721-9081
Practice Address - Street 1:1120 15TH ST # AF-1016
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-5812
Practice Address - Country:US
Practice Address - Phone:706-721-2705
Practice Address - Fax:706-721-9081
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC149365208000000X
GA72341207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics