Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 2002005827 | MO |
Y | 207VE0102X | Reproductive Endocrinologist | MD27368 | OR |
NPI | 1073531554 |
---|---|
Provider Name | Dr. Aimee S Chang |
First Address | Portland, OR 97223-5442 |
Second Address | Portland, OR 97223-5442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 18/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
157258 | MO-BLUE SHIELD (01) | |
H56416 | (02) |