Provider Demographics
NPI:1578750519
Name:LEE, CHENG VANG (MD)
Entity Type:Individual
Prefix:
First Name:CHENG
Middle Name:VANG
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8402
Mailing Address - Country:US
Mailing Address - Phone:724-632-6801
Mailing Address - Fax:724-632-6312
Practice Address - Street 1:86 MCCLELLANDTOWN RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-5527
Practice Address - Country:US
Practice Address - Phone:724-430-7990
Practice Address - Fax:724-430-7993
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2018-06-22
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Provider Licenses
StateLicense IDTaxonomies
PAMD437350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024260560002Medicaid