Individual
KEVIN J CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 W IRONWOOD DR STE 378, COEUR D ALENE, ID 83814-4401
(208) 625-3555
(208) 769-8616
Mailing address
700 W IRONWOOD DR STE 378, COEUR D ALENE, ID 83814-4401
(086) 253-5552
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
M9397
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807244200
—
ID
Enumeration date
01/30/2007
Last updated
07/28/2025
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