Individual
KEON CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 S MERRIMAN RD, WESTLAND, MI 48186-5544
(734) 729-3133
Mailing address
5623 E DUNBAR RD, MONROE, MI 48161-9127
(734) 241-3891
(734) 241-0014
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301037628
MI
2084P0800X
Psychiatry Physician
Primary
037628
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2884620 10
—
MI
Enumeration date
01/17/2006
Last updated
10/21/2009
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