Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 59615 | GA |
N | 207VX0000X | Obstetrician | 4301082153 | MI |
NPI | 1386859163 |
---|---|
Provider Name | Yoon Jeong Chang |
First Address | Atlanta, GA 30327-2253 |
Second Address | Austell, GA 30106-1124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 30/06/2011 |