Provider Demographics
NPI:1124581756
Name:CHIANG, CHENG CHUAN (DO)
Entity Type:Individual
Prefix:
First Name:CHENG CHUAN
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:CHIANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:600 NORTH WOLFE STREET
Mailing Address - Street 2:PHIPPS 174
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287
Mailing Address - Country:US
Mailing Address - Phone:410-502-2447
Mailing Address - Fax:410-502-2419
Practice Address - Street 1:600 NORTH WOLFE STREET
Practice Address - Street 2:PHIPPS 174
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:410-502-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program