Healthcare Provider Details

I. General information

NPI: 1013096759
Provider Name (Legal Business Name): RICHARD ZHANG CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 10/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6149 SAINT ANDREWS RD SUITE C
COLUMBIA SC
29212-3149
US

IV. Provider business mailing address

6149 SAINT ANDREWS RD SUITE C
COLUMBIA SC
29212-3149
US

V. Phone/Fax

Practice location:
  • Phone: 803-233-3420
  • Fax: 888-688-1934
Mailing address:
  • Phone: 803-233-3420
  • Fax: 888-688-1934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number22790
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: