Provider Demographics
NPI:1710910211
Name:CHEEK, SAMUEL BURCH JR (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:BURCH
Last Name:CHEEK
Suffix:JR
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 BROADMOOR DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6583
Mailing Address - Country:US
Mailing Address - Phone:865-380-0938
Mailing Address - Fax:865-977-5449
Practice Address - Street 1:427 BROADMOOR DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-6583
Practice Address - Country:US
Practice Address - Phone:865-380-6516
Practice Address - Fax:865-977-5449
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30135207P00000X, 207ZP0102X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG75886Medicare UPIN