Provider Demographics
NPI:1548353287
Name:ROE, MENG CHENG (MD)
Entity type:Individual
Prefix:
First Name:MENG
Middle Name:CHENG
Last Name:ROE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1380 LUSITANA STREET
Mailing Address - Street 2:SUITE #804
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-524-3020
Mailing Address - Fax:808-524-8163
Practice Address - Street 1:1380 LUSITANA STREET
Practice Address - Street 2:SUITE #804
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-524-3020
Practice Address - Fax:808-524-8163
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD8397208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI508301Medicaid
HI23088-8OtherHMSA
HIG01791Medicare ID - Type Unspecified
HI508301Medicaid