Individual
DR. BOONCHOO CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
417 W HIGH ST, DOWAGIAC, MI 49047-1906
(269) 782-7150
(269) 782-7020
Mailing address
417 W HIGH ST, DOWAGIAC, MI 49047-1906
(269) 782-7150
(269) 782-7020
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
4301031400
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301031400
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093701
—
MI
Enumeration date
12/28/2006
Last updated
12/28/2007
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