Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036121683 | IL |
N | 208600000X | Surgeon | 036121683 | IL |
Y | 208200000X | Surgeon | 296023 | NY |
Y | 208600000X | Surgeon | 296023 | NY |
N | 208200000X | Surgeon | 35 128514 | OH |
N | 208600000X | Surgeon | 35 128514 | OH |
N | 208200000X | Surgeon | A108083 | CA |
N | 208600000X | Surgeon | A108083 | CA |
N | 2086S0102X | Surgical Critical Care | 249593 | MA |
N | 2086S0102X | Surgical Critical Care | 296023 | NY |
NPI | 1134375512 |
---|---|
Provider Name | Dr. Philip Hyungjin Chang |
First Address | Cincinnati, OH 45263-6256 |
Second Address | New York, NY 10065-4870 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2008 |
Last Update Date | 22/09/2021 |