Basic Information
| Provider Information | |||||||||
| NPI: | 1164492427 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHENG | ||||||||
| FirstName: | SHI-CHI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 930 FRANKLIN ST SE | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358014312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565394080 | ||||||||
| FaxNumber: | 2565394099 | ||||||||
| Practice Location | |||||||||
| Address1: | 930 FRANKLIN ST SE | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358014312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565394080 | ||||||||
| FaxNumber: | 2565394099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2006 | ||||||||
| LastUpdateDate: | 12/03/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 21892 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 000037984 | 05 | AL | MEDICAID | 111650 | 05 | AL | MEDICAID | 51037984 | 01 | AL | BCBS | OTHER | 51049391 | 01 | AL | BCBS | OTHER | P00762369 | 01 | AL | RAILROAD MEDICARE | OTHER | 51049233 | 01 | AL | BCBS | OTHER | 51049392 | 01 | AL | BCBS | OTHER | 51592643 | 01 | AL | BCBS | OTHER | 111651 | 05 | AL | MEDICAID | 51041431 | 01 | AL | BCBS | OTHER | 060052959 | 01 | RAILROAD MEDICARE | OTHER | 111652 | 05 | AL | MEDICAID | 51049389 | 01 | AL | BCBS | OTHER | 51049393 | 01 | AL | BCBS | OTHER | 111653 | 05 | AL | MEDICAID | 111656 | 05 | AL | MEDICAID | 51040394 | 01 | AL | BCBS | OTHER | 111657 | 05 | AL | MEDICAID | 3113580 | 01 | TN | BCBS | OTHER | 3334302 | 05 | TN | MEDICAID | 51047238 | 01 | AL | BCBS | OTHER | 51049390 | 01 | AL | BCBS | OTHER | 5217657 | 01 | AETNA | OTHER | 25-10290 | 01 | UNITED HEALTHCARE | OTHER |