Individual
CARLOS KENNETH CHENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Mailing address
4464 S DIXIE HWY, MIDDLETOWN, OH 45005-5464
(513) 649-8008
(513) 649-8004
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35-077986
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00744861
MEDICAID LEGACY NUMBER--ODADAS
OH
01
—
0074946
MEDICAID--ODMH
OH
05
—
2310190
—
OH
Enumeration date
07/14/2006
Last updated
05/16/2013
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