Provider Demographics
NPI:1730261876
Name:CHEUNG, NOAH MINGYIN (DPM)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:MINGYIN
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:NOAH
Other - Middle Name:MINGYIN
Other - Last Name:CHEUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:12114-A HERITAGE PARK CIRCL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906
Mailing Address - Country:US
Mailing Address - Phone:301-962-4188
Mailing Address - Fax:301-251-1397
Practice Address - Street 1:12114A HERITAGE PARK CIR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-4554
Practice Address - Country:US
Practice Address - Phone:301-962-4188
Practice Address - Fax:301-251-1397
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01044213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9332154Medicaid
MD7634188 00Medicaid
VA9332154Medicaid