Organization
BOONCHOO CHANG M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOONCHOO CHANG M.D. (PRESIDENT)
(269) 782-7150
Entity
Organization
Contact information
Practice address
417 W HIGH ST, DOWAGIAC, MI 49047-1906
(269) 782-7150
(269) 782-7020
Mailing address
417 W HIGH ST, DOWAGIAC, MI 49047-1906
(269) 782-7150
(269) 782-7020
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
BC031400
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093701
—
MI
Enumeration date
03/29/2007
Last updated
12/20/2007
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