1912330697 NPI number — DR. YIK HON MARC CHENG MD

Table of content: DR. YIK HON MARC CHENG MD (NPI 1912330697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912330697 NPI number — DR. YIK HON MARC CHENG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHENG
Provider First Name:
YIK HON MARC
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912330697
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 E. WASHINGTON STREET
Provider Second Line Business Mailing Address:
UNIT 304, STERLING 411 LOFTS
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-834-0477
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 E MEDICAL CENTER DRIVE
Provider Second Line Business Practice Location Address:
FLOOR 2 SPC 5853, UMHS, CARDIOVASCULAR CENTER
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48109-5853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-936-6858
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  4301102584 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)