Provider Demographics
NPI:1194707281
Name:ZHENG, SAM XIANG-MING (MD)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:XIANG-MING
Last Name:ZHENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:416 E MONROE ST
Mailing Address - Street 2:STE 200
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-2371
Mailing Address - Country:US
Mailing Address - Phone:574-232-8119
Mailing Address - Fax:574-288-0235
Practice Address - Street 1:416 E MONROE ST
Practice Address - Street 2:STE 200
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-2371
Practice Address - Country:US
Practice Address - Phone:574-232-8119
Practice Address - Fax:574-288-0235
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01055569207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN352149231OtherTAX ID
IN200362590Medicaid
IN352149231OtherTAX ID
IN200362590Medicaid