Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD425419 | PA |
N | 207YP0228X | Pediatric Otolaryngology | MD425419 | PA |
N | 207YS0123X | Facial Plastic Surgeon | MD425419 | PA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD425419 | PA |
NPI | 1427053370 |
---|---|
Provider Name | Dr. John Chun-Lu Chang |
First Address | Chambersburg, PA 17201-4232 |
Second Address | Chambersburg, PA 17201-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 06/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101236084 0001 | (05) | PA |
120420405 | DEPT OF LABOR (01) | PA |
1544525 | GATEWAY (01) | PA |
161083 | UNISON (01) | PA |
2129690 | MAMSI (01) | PA |
2138338 | FIRST HEALTH (01) | PA |
25-1716306 | DEVON (01) | PA |
25-1716306 | GREATWEST (01) | PA |
25-1716306 | HEALTHNET/TRICARE (01) | PA |
25-1716306 | INFORMED (01) | PA |
25-1716306 | INTERGROUP (01) | PA |
25-1716306 | MULTIPLAN/PHCS (01) | PA |
25-1716306 | SOUTH CENTRAL PREFERRED (01) | PA |
3698774 | AETNA HMO (01) | PA |
426713 | HEALTH AMERICA (01) | PA |
50044493 | CAPITAL BLUECROSS (01) | PA |
7615333 | AETNA NON-HMO (01) | PA |
867633 | MEDICARE GROUP # (01) | PA |
BC6904836 | DEA (01) | PA |
CH1658644 | HIGHMARK BLUE SHIELD (01) | PA |
G920-0039/647200-02 | CAREFIRST (01) | PA |
H89895 | (02) | PA |
MD425419 | LICENSE (01) | PA |
P00222626 | RAILROAD MEDICARE (01) | PA |