Healthcare Provider Details

I. General information

NPI: 1831718808
Provider Name (Legal Business Name): CHENG WEI HSEU CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2020
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 19TH ST S # LHRB112
BIRMINGHAM AL
35233-1926
US

IV. Provider business mailing address

1177 BERWICK RD
BIRMINGHAM AL
35242-7121
US

V. Phone/Fax

Practice location:
  • Phone: 205-435-1732
  • Fax:
Mailing address:
  • Phone: 205-435-1732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-139346
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: