Individual
JACK C CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
706 ROGERS ST, LOWELL, MA 01852-4338
(978) 937-9333
(978) 937-9992
Mailing address
706 ROGERS ST, LOWELL, MA 01852-4338
(978) 937-9333
(978) 937-9992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
74694
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074694
TUFTS
MA
05
—
3103391
—
MA
01
—
J13158
BLUE CROSS BLUE SHIELD
MA
Enumeration date
09/11/2007
Last updated
11/26/2007
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