Individual
DR. MAN-KUANG CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
820 PRUDENTIAL DR STE 515, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32207-8207
(904) 396-4886
(904) 390-7487
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME103472
FL
207RI0200X
Infectious Disease Physician
Primary
ME103472
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001467800
—
FL
01
—
P00787542
RAILROAD MEDICARE
FL
Enumeration date
07/05/2007
Last updated
11/20/2024
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