Individual
DR. WILBUR CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.-PH.D.
Contact information
Practice address
10810 CONNECTICUT AVE, RADIOLOGY, KENSINGTON, MD 20895-2138
(301) 929-7100
(301) 929-7597
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
(301) 929-7597
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
D0063067
MD
2085R0202X
Diagnostic Radiology Physician
0101248264
VA
2085R0202X
Diagnostic Radiology Physician
Primary
88247
GA
2085R0202X
Diagnostic Radiology Physician
D0063067
MD
2085R0202X
Diagnostic Radiology Physician
MD038973
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073
AAD BLUE CHOICE
MD
01
—
154636ZDYC
RR MEDICARE ARA PTAN
MD
05
—
417262100
—
MD
01
—
P00751352
RR MEDICARE PTAN - AAD
—
01
—
S645
AAD BCBS
MD
Enumeration date
09/28/2006
Last updated
02/08/2022
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