Provider Demographics
NPI:1467870253
Name:CHENG, TABITHA (MD)
Entity Type:Individual
Prefix:DR
First Name:TABITHA
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 1:60 ROBERTS DR STE 313
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-3254
Mailing Address - Country:US
Mailing Address - Phone:413-398-5733
Mailing Address - Fax:
Practice Address - Street 1:60 ROBERTS DR STE 313
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3254
Practice Address - Country:US
Practice Address - Phone:413-398-5733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA142228207P00000X
MA279118207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine