Individual
SAM CHENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
308 S CHURCH ST, FAYETTE, MO 65248-1243
(660) 642-5911
(660) 248-2217
Mailing address
1103 W BROADWAY APT A, COLUMBIA, MO 65203-2177
(631) 747-8371
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2024022777
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/15/2020
Last updated
06/20/2024
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