Provider Demographics
NPI:1356835813
Name:CHENG, OLIVIA (MD)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29201 TELEGRAPH RD STE 324
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-7646
Mailing Address - Country:US
Mailing Address - Phone:248-357-5100
Mailing Address - Fax:
Practice Address - Street 1:29201 TELEGRAPH RD STE 324
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7646
Practice Address - Country:US
Practice Address - Phone:248-357-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301508785207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology