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Individual

DR. CHUL CHANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 MEDICAL PARK DR, WATERVLIET, MI 49098-9225
(269) 463-2449
Mailing address
450 MEDICAL PARK DR, WATERVLIET, MI 49098-8531
(269) 463-6900
(269) 463-6900

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CC043583
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0M55810
MEDICARE - BANGOR
MI
01
1101102151
BLUECROSSBLUESHIELDOFMI
MI
01
110H010030
BCBSM - BANGOR
MI
05
2589390
MI
05
3208317
MI
Enumeration date
06/16/2006
Last updated
11/23/2009
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