Individual
MRS. SUSAN L CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8919 SHADY GROVE CT, GAITHERSBURG, MD 20877-1308
(240) 644-2303
Mailing address
8919 SHADY GROVE CT, GAITHERSBURG, MD 20877-1308
(240) 644-2303
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
7CQ5-RC1-TX59
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C-520-778-522-108
—
MD
05
—
C520778522108
—
MD
Enumeration date
12/06/2021
Last updated
12/06/2021
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