Provider Demographics
NPI:1871593954
Name:GAO, HUA (MD)
Entity type:Individual
Prefix:
First Name:HUA
Middle Name:
Last Name:GAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6530 FARMINGTON RD
Mailing Address - Street 2:300
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3216
Mailing Address - Country:US
Mailing Address - Phone:248-661-5100
Mailing Address - Fax:248-661-5090
Practice Address - Street 1:6530 FARMINGTON RD
Practice Address - Street 2:OPHTHALMOLOGY
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322
Practice Address - Country:US
Practice Address - Phone:248-661-5100
Practice Address - Fax:248-661-5090
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01051585A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000301691OtherANTHEM
IN200432130Medicaid
IN000000301691OtherANTHEM
IN200432130Medicaid