CHEUNG POR PUN (NPI# 1407894488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407894488 |
| Entity Type | Individual |
| Full Name | CHEUNG POR PUN |
| Credential | M.D. |
| Practice Address |
1825 Logan Ave Waterloo IA 50703-1916 |
| Mailing Address |
Po Box 2758 Waterloo IA 50704-2758 |
| Practice Telephone | 3192353716 |
| Practice Fax Number | 3192331630 |
| Mailing Telephone | 3192353716 |
| Mailing Fax Number | 3192331630 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2007-09-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
19597 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | JOHN DEERE HEALTH | 421417307L1 | 01 |
| IA | WELLMARK HEALTH | 08697 | 01 |
| Street Address |
1825 LOGAN AVE |
| City | WATERLOO |
| State | IA |
| Zip Code | 50703-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881680130 | Jeffrey David Wilkins | Emergency Medicine | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2005-09-22 |
| 1922614379 | Jade Marie Kalina | Nurse Practitioner | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-09-21 |
| 1942818877 | Julia Fifield | Pharmacist | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-07-16 |
| 1154939262 | Jacob John Peterson | Pharmacist | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-07-15 |
| 1962025767 | Abby Staudt | Nurse Practitioner | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-05-27 |
| 1083237234 | Kathryn E Soeder | Nurse Anesthetist, Certified Registered | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-05-22 |
| 1871120147 | Carolyn Anna Steenhoek | Physician Assistant | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-03-25 |
| 1497387989 | Nupur Chopra Harkness | Pharmacist | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-02-12 |
| 1750912523 | Patricia Leininger | Dietitian, Registered | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-01-30 |
| 1932739331 | Allison Katherine Bohlman | Dietitian, Registered | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-01-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306363841 | Kristie Wood | Counselor | 1420 W. Donald St, Waterloo, IA 50703 | 2017-08-25 |
| 1215359054 | Chuck Corwin | Counselor | 607 Sycamore Street, Suite 300, Waterloo, IA 50703 | 2014-01-14 |
| 1679672554 | Linda D Bartollas | Social Worker | 146 West Dale Street, Suite 101, Waterloo, IA 50703 | 2006-09-21 |
| 1558477745 | Brent Matthew Hintz | Obstetrics & Gynecology | 212 West Dale St., Suite 402, Waterloo, IA 50703 | 2006-08-21 |
| 1588629729 | Mir Ahmad Waziri | Pediatrics | 212 W Dale Street, Suite 302, Waterloo, IA 50703 | 2006-04-19 |
| 1568432615 | Wei Yang | Pathology | Northeast Iowa Pathology Associates, PC, 1825 Logan Avenue, Waterloo, IA 50703 | 2006-01-23 |
| 1689158040 | Megan Elizabeth O'neal | Nurse Practitioner | 1631 Logan Ave, Waterloo, IA 50703 | 2018-09-21 |
| 1972031359 | Stephanie Rose Smith | Nurse Practitioner | 1631 Logan Ave, Waterloo, IA 50703 | 2017-05-30 |
| 1801263462 | Krissy Jean Wieland | Nurse Practitioner | 220 Franklin St, Waterloo, IA 50703 | 2015-08-28 |
| 1649670852 | Sapna Aggarwal | Dentist | 905 Franklin St, Waterloo, IA 50703 | 2014-08-26 |
| Find all providers in zip 50703 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285793844 | Wayne Leroy Ventling II | Radiology | 4150 Kimball Avenue, Waterloo, IA 50701 | 2006-12-08 |
| 1407003015 | Murali Krishna Surnedi | Radiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2008-08-26 |
| 1528214970 | Gopi Kota | Radiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2008-08-15 |
| 1851576946 | Rajeev Anugu | Radiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2008-01-08 |
| 1114019312 | Southern Illinois Imaging Associates, LLC | Radiology | 509 Hamacher St, Suite 300, Waterloo, IL 62298-1592 | 2006-09-28 |
| 1083656995 | James Vincent Connell Jr. | Radiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2006-06-12 |
| 1225076029 | Greg Evan Raecker | Radiology | 1731 W Ridgeway Ave, Ste 101, Waterloo, IA 50701-4591 | 2006-06-03 |
| 1285680736 | Lawrence Arthur Liebscher | Radiology | 1731 W Ridgeway Ave, Ste 101, Waterloo, IA 50701-4543 | 2006-05-26 |
| 1821044587 | John Ireland Halloran | Radiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2006-05-25 |
| 1386698009 | Stephen Dale Frazier | Radiology | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2006-05-19 |
| Find all providers in WATERLOO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.