Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD035361L | PA |
NPI | 1548292105 |
---|---|
Provider Name | Chris Chang |
First Address | Allentown, PA 18105-1754 |
Second Address | Allentown, PA 18103-6372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 01/04/2011 |