Individual
CHUNG-HO CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 BEAUBIEN ST, CHILDREN'S HOSPITAL OF MI PATHOLOGY, DETROIT, MI 48201-2119
(313) 745-2553
(313) 993-8754
Mailing address
1420 STEPHENSON HWY, SUITE 400-CREDENTIALING, TROY, MI 48083-1189
(248) 581-5974
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301031363
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220F362370
BCBSM
MI
05
—
2785758
—
MI
Enumeration date
03/22/2006
Last updated
01/15/2014
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