Individual
HENRY T CHANG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-2300
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20724
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30119100
—
WI
Enumeration date
11/30/2005
Last updated
07/08/2007
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