Individual
MATTHEW CHENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2094 E. STATE ST., SUITE G, SALEM, OH 44460-9998
(330) 337-0177
(330) 337-0178
Mailing address
8423 MARKET ST., SUITE 100, YOUNGSTOWN, OH 44512-6778
(330) 707-5864
(330) 707-2210
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
35092716
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000600306
ANTHEM BLUE CROSS/BLUE SHIELD
OH
01
—
020567610
FEDERAL BLACK LUNG
OH
01
—
020567610L
AULTCARE
OH
05
—
2907420
—
OH
Enumeration date
05/09/2006
Last updated
06/19/2009
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