Individual
MS. AMIE C CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
11525 OLDE CABIN RD, CREVE COEUR, MO 63141-7146
(314) 997-0554
(314) 997-5086
Mailing address
11525 OLDE CABIN RD, CREVE COEUR, MO 63141-7146
(314) 997-0554
(314) 997-5086
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2005031799
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000097382
MEDICARE LEGACY
MO
01
—
218233
BLUE CROSS/BLUE SHIELD
—
Enumeration date
08/20/2006
Last updated
02/27/2014
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