Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DO-05524 | IA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 75561-21 | WI |
NPI | 1518451970 |
---|---|
Provider Name | Dr. Andrew Chang |
First Address | Madison, WI 53792-0001 |
Second Address | Madison, WI 53792-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2018 |
Last Update Date | 03/07/2021 |