MEDICARE: DR. PETER T CHEUNG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	7867	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E11264	OTHER	NH	HARVARD PILGRIM
2	0107208Y0NH01	OTHER	NH	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861480162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER T CHEUNG M.D.

Provider Business Mailing Address
First Line	:	1750 ELM STREET
Second Line	:	SUITE 201C
City	:	MANCHESTER
State	:	NH
Zip	:	03104-2903
Country	:	US
Telephone Number	:	603-641-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 ELM STREET
Second Line	:	SUITE 201C
City	:	MANCHESTER
State	:	NH
Zip	:	03104-2903
Country	:	US
Telephone Number	:	603-641-5800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	09/20/2012

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