Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 2008004914 | MO |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 41769 | AZ |
NPI | 1154522910 |
---|---|
Provider Name | Dr. Michael S Chang |
First Address | Mesa, AZ 85202 |
Second Address | Mesa, AZ 85202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 22/06/2012 |