Organization
LAWRENCE D CHANG M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA BOLTE (BILLING)
(302) 355-0005
Entity
Organization
Contact information
Practice address
774 CHRISTIANA ROAD, SUITE 101, NEWARK, DE 19713
(302) 355-0005
(302) 709-6161
Mailing address
774 CHRISTIANA ROAD, SUITE 101, NEWARK, DE 19713
(302) 355-0005
(302) 709-6161
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
C10004311
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000562701
—
DE
01
—
G00259
MEDICARE GROUP
DE
Enumeration date
02/21/2008
Last updated
03/31/2025
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