Provider Demographics
NPI:1811177918
Name:CHEUNG, KATHARINE LANA (MD)
Entity type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:LANA
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 S PROSPECT ST
Mailing Address - Street 2:UHC MED-NEPHROLOGY
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3456
Mailing Address - Country:US
Mailing Address - Phone:802-847-3572
Mailing Address - Fax:802-847-8736
Practice Address - Street 1:1 S PROSPECT ST
Practice Address - Street 2:UHC MED-NEPHROLOGY
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3456
Practice Address - Country:US
Practice Address - Phone:802-847-3572
Practice Address - Fax:802-847-8736
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042.0012752207RN0300X, 207R00000X, 208M00000X
CAA105333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1024184Medicaid