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Individual

DR. SUNG KYU CHANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7351 OLD MOON RD, COLUMBUS, GA 31909-7291
(706) 653-7000
(706) 653-7800
Mailing address
7351 OLD MOON RD, COLUMBUS, GA 31909-7291
(706) 653-7000
(704) 377-3389

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
52693
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141512294A
GA
01
511I090013
MEDICARE PTAN
GA
01
52261875-001
BCBSGA
GA
Enumeration date
04/13/2006
Last updated
10/17/2010
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