Provider Demographics
NPI:1942387824
Name:FENG, LU-JEAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:LU-JEAN
Middle Name:M
Last Name:FENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31200 PINETREE RD
Mailing Address - Street 2:
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-5928
Mailing Address - Country:US
Mailing Address - Phone:216-831-7007
Mailing Address - Fax:
Practice Address - Street 1:31200 PINETREE ROAD
Practice Address - Street 2:
Practice Address - City:PEPPER PIKE
Practice Address - State:OH
Practice Address - Zip Code:44124-5928
Practice Address - Country:US
Practice Address - Phone:216-831-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-5358F208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA17073Medicare UPIN