Provider Demographics
NPI:1720038201
Name:WENG, SAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:S
Last Name:WENG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:940 N NEW ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-2756
Practice Address - Country:US
Practice Address - Phone:610-868-9411
Practice Address - Fax:484-403-4013
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD035608L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA140672OtherHIGHMARK PA BLUE SHIELD
PA112925959OtherPALMETTO GBA MEDICARE
PA00084735000001Medicaid
PA01055104OtherCAPITAL BLUE CROSS
PA00084735000001Medicaid
PA140672H9MMedicare PIN
PA01055104OtherCAPITAL BLUE CROSS