Individual
BENJAMIN BANSUN CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
740 HIGH ST STE 2001, WILLIAMSPORT, PA 17701-3102
(703) 212-8055
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
(570) 326-8723
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
1697666
NY
2086S0129X
Vascular Surgery Physician
169766
NY
2086S0129X
Vascular Surgery Physician
Primary
MD476246
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
169766
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01022251
—
NY
Enumeration date
10/28/2005
Last updated
01/06/2022
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