Provider Demographics
NPI:1548216229
Name:CHENG, JOHN I (MD)
Entity Type:Individual
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First Name:JOHN
Middle Name:I
Last Name:CHENG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 422002
Mailing Address - Street 2:PEDIATRIC EMERGENCY MEDICINE ASSOCIATES, LLC
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-9002
Mailing Address - Country:US
Mailing Address - Phone:770-938-0772
Mailing Address - Fax:770-621-9230
Practice Address - Street 1:1001 JOHNSON FERRY RD
Practice Address - Street 2:CHILDREN'S HEALTHCARE OF ATLANTA @ SCOTTISH RITE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1605
Practice Address - Country:US
Practice Address - Phone:404-785-2007
Practice Address - Fax:404-785-5846
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2014-10-29
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Provider Licenses
StateLicense IDTaxonomies
GA531172080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA788292003Medicaid