Provider Demographics
NPI:1942753249
Name:CHENG, QIAN (PHD, CLINICAL CHEM)
Entity Type:Individual
Prefix:DR
First Name:QIAN
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:PHD, CLINICAL CHEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 HALLECK LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-7566
Mailing Address - Country:US
Mailing Address - Phone:520-465-3622
Mailing Address - Fax:
Practice Address - Street 1:2540 HALLECK LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-7566
Practice Address - Country:US
Practice Address - Phone:520-465-3622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDI 46504291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory