Provider Demographics
NPI:1730251653
Name:CHENG, SHI FAY (MD)
Entity type:Individual
Prefix:
First Name:SHI FAY
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 21ST AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4908
Mailing Address - Country:US
Mailing Address - Phone:615-327-9797
Mailing Address - Fax:615-613-0329
Practice Address - Street 1:2400 PATTERSON ST STE 204
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6500
Practice Address - Country:US
Practice Address - Phone:615-988-2071
Practice Address - Fax:615-613-0329
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45940207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I078993Medicaid
TN103I078993Medicaid
GA007262174Medicaid
CO63322013Medicaid
GA1730251653OtherBCBSGA PROVIDER NUMBER
CO51538OtherLICENSE
CO269071YNSCMedicare PIN
GA1730251653OtherBCBSGA PROVIDER NUMBER
BC4924913OtherDEA