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Individual

BRIAN K CHANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11050 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845
(260) 266-9100
(260) 266-9110
Mailing address
7910 W JEFFERSON BLVD STE 110, FORT WAYNE, IN 46804-4159
(260) 436-4116
(260) 459-2504

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01063272A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1245364926
MI
05
200857850
IN
05
2735259
OH
Enumeration date
03/15/2007
Last updated
06/15/2018
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