Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | 43893 | CO |
Y | 2080P0202X | Pediatric Cardiologist | MD436731 | PA |
NPI | 1144305491 |
---|---|
Provider Name | Dennis Chang |
First Address | Hershey, PA 17033-0858 |
Second Address | Harrisburg, PA 17112-3247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 01/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
44906838 | (05) | CO |
I44346 | (02) |