Individual
DR. BRUCE SHOO TANG CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6400 DUTCHMANS PKWY, STE 250, LOUISVILLE, KY 40205-3340
(502) 587-9660
(502) 540-5615
Mailing address
6400 DUTCHMANS PKWY, STE 250, LOUISVILLE, KY 40205-3340
(502) 587-9660
(502) 540-5615
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
23110
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64231103
—
KY
01
—
ANTHEM
000000062787
KY
01
—
PASSPORT
1050699
KY
Enumeration date
06/09/2005
Last updated
08/29/2007
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