Individual
CHANG KYEONG OH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2544 COURT DR STE G, GASTONIA, NC 28054-3450
(704) 854-9990
(704) 854-9045
Mailing address
2544 COURT DR STE G, GASTONIA, NC 28054-3450
(704) 854-9990
(704) 854-9045
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
01067834A
IN
207RG0100X
Gastroenterology Physician
Primary
2016-02536
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000659151
BCBS
IN
05
—
200981250
—
IN
Enumeration date
06/12/2006
Last updated
01/25/2017
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