Provider Demographics
NPI:1851490775
Name:CHING, YIMING AVERY (MD)
Entity Type:Individual
Prefix:
First Name:YIMING
Middle Name:AVERY
Last Name:CHING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1618
Mailing Address - Country:US
Mailing Address - Phone:413-794-3909
Mailing Address - Fax:
Practice Address - Street 1:3500 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1150
Practice Address - Country:US
Practice Address - Phone:413-794-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230078208600000X, 2086S0129X
KY490242086S0129X
TXP86522086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201358410A (KOHMG)Medicaid
KY7100402650 (KOHMG)Medicaid
KYP01650827 RR (KOHMG)Medicare PIN
KYK202620 (KOHMG)Medicare PIN