Provider Demographics
NPI:1013189802
Name:GENE CHENG MD
Entity Type:Organization
Organization Name:GENE CHENG MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-622-4400
Mailing Address - Street 1:6 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5211
Mailing Address - Country:US
Mailing Address - Phone:207-622-4400
Mailing Address - Fax:207-621-2483
Practice Address - Street 1:6 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5211
Practice Address - Country:US
Practice Address - Phone:207-622-4400
Practice Address - Fax:207-621-2483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME015417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty