Individual
CHENG DU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12750 ST FRANCIS DR, CROWN POINT, IN 46307-0264
(219) 757-6121
(219) 681-6897
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01055815A
IN
2084N0400X
Neurology Physician
25MA09009900
NJ
208M00000X
Hospitalist Physician
01055815A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221796
ANTHEM PROVIDER NUMBER
IN
01
—
11383713
CAQH NUMBER
IN
05
—
200376880
—
IN
01
—
9396994
PHCS PID NUMBER
IN
Enumeration date
03/14/2006
Last updated
01/15/2024
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