Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 04-43924 | KS |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 04-43924 | KS |
NPI | 1194179747 |
---|---|
Provider Name | Dr. Christina Cheng |
First Address | Lees Summit, MO 64081-2116 |
Second Address | Lees Summit, MO 64081-2116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2016 |
Last Update Date | 14/05/2021 |