Provider Demographics
NPI:1891143681
Name:CHENG, KAI N (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KAI
Middle Name:N
Last Name:CHENG
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:105 TOPSHAM FAIR MALL RD STE 8
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1773
Mailing Address - Country:US
Mailing Address - Phone:207-798-6333
Mailing Address - Fax:
Practice Address - Street 1:105 TOPSHAM FAIR MALL RD STE 8
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086
Practice Address - Country:US
Practice Address - Phone:207-798-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA5619363A00000X
MEPA1614363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant