Individual
CHANG HWAN BAHNG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
915 MICHIGAN ST, SIDNEY, OH 45365-2401
(937) 498-2311
Mailing address
PO BOX 5128, LIMA, OH 45802-5128
(419) 224-5707
(419) 229-0040
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.041023
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000317647
ANTHEM BCBS
OH
05
—
0443587
—
OH
01
—
P00081568
RAILROAD MEDICARE
OH
Enumeration date
03/24/2006
Last updated
07/08/2007
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