Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 5173 | AK |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 5173 | AK |
NPI | 1225066095 |
---|---|
Provider Name | Eugene M Chang |
First Address | Anchorage, AK 99508-5230 |
Second Address | Anchorage, AK 99508-5230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 29/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1015495 | (05) | AK |