Provider Demographics
NPI:1730132366
Name:FU, CHENG SHUNG (MD)
Entity type:Individual
Prefix:DR
First Name:CHENG
Middle Name:SHUNG
Last Name:FU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6636 MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5967
Mailing Address - Country:US
Mailing Address - Phone:716-633-0541
Mailing Address - Fax:716-633-8889
Practice Address - Street 1:6636 MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5967
Practice Address - Country:US
Practice Address - Phone:716-633-0540
Practice Address - Fax:716-633-0543
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2019-10-13
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Provider Licenses
StateLicense IDTaxonomies
NY118876207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0400556OtherINDEPENDANT HEALTH
NY5068341OtherCOMMUNITY BLUE
NY00592003Medicaid
NY0010058601OtherUNIVERA
NY0010058601OtherUNIVERA
NYA68341Medicare PIN