Provider Demographics
NPI:1134139306
Name:ROLANDO CHENG MD PSC
Entity Type:Organization
Organization Name:ROLANDO CHENG MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-235-0960
Mailing Address - Street 1:1210 KY HIGHWAY 36 E STE G2
Mailing Address - Street 2:
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-7490
Mailing Address - Country:US
Mailing Address - Phone:859-987-7112
Mailing Address - Fax:
Practice Address - Street 1:1210 KY HIGHWAY 36 E STE G2
Practice Address - Street 2:
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-7490
Practice Address - Country:US
Practice Address - Phone:859-987-7112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21326208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64213267Medicaid
KY90012188OtherMEDICAID DME
KY65901761Medicaid
14958526000OtherOHIO BUREAU OF WORKERS COMP
KY1321501OtherMEDICARE
000000047713OtherANTHEM
KY1061251OtherPASSPORT
KY65901761Medicaid
KY65901761Medicaid
KY64213267Medicaid