Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101230703 | VA |
N | 208600000X | Surgeon | 0101230703 | VA |
Y | 2086X0206X | Surgical Oncologist | 0101230703 | VA |
NPI | 1225012909 |
---|---|
Provider Name | Eugene Y Chang |
First Address | Suffolk, VA 23435-2663 |
Second Address | Suffolk, VA 23435-2663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 28/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H34708 | (02) | VA |