Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 17979-8 | SC |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 17978 | SC |
NPI | 1336255777 |
---|---|
Provider Name | Eugene Y Chang |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 21/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
179782 | (05) | SC |
3922 | USC MEDICARE GROUP (01) | SC |
H64026 | (02) | SC |
USC0001 | (05) | SC |