Cheng T Pan MD Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35056072 Issued in OH

Legal business name

CHENG T PAN MD INC

Practice address

227 South Garber Drive
Tipp City, OH 45371-1183

Phone

(937) 667-6774

Fax

(937) 667-2826

NPI assigned

Apr 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Cheng Tsing Pan, MD

Title

President of Corporation

Phone

(937) 667-6774

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467676494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 SOUTH GARBER DRIVE",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453711183",
            "telephone_number": "937-667-6774",
            "fax_number": "937-667-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 SOUTH GARBER DRIVE",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453711183",
            "telephone_number": "937-667-6774",
            "fax_number": "937-667-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENG T PAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "CHENG",
        "authorized_official_middle_name": "TSING",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "937-667-6774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35056072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0817629",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Tipp City, OH
• Providers in Tipp City, OH by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.