Provider Demographics
NPI:1720245038
Name:CHENG, MING LIANG
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:LIANG
Last Name:CHENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CLAVERICK ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4144
Mailing Address - Country:US
Mailing Address - Phone:401-455-1749
Mailing Address - Fax:401-455-1292
Practice Address - Street 1:55 CLAVERICK ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4144
Practice Address - Country:US
Practice Address - Phone:401-455-1749
Practice Address - Fax:401-455-1292
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD12685207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery