Individual
PETER TRAVIS RIAD CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
606 W KENNEDY BLVD, TAMPA, FL 33606-1415
(813) 844-3829
Mailing address
PO BOX 1289, TAMPA, FL 33601-1289
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME108738
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003496400
—
FL
01
—
14F13
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/10/2008
Last updated
09/07/2016
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