Individual
DR. KI-EUN CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY STREET APC 6, PROVIDENCE, RI 02903-4923
(401) 793-9166
(401) 444-2788
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
A147705
CA
207T00000X
Neurological Surgery Physician
Primary
MD18382
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/02/2016
Last updated
05/25/2022
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