Individual
DR. SU-PEN BOBBY CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 638-6950
Mailing address
801 ALBANY ST, FL G, BOSTON, MA 02119
(617) 414-5405
(617) 414-6031
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
76235
MA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
76235
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110051609B
—
MA
Enumeration date
05/19/2006
Last updated
10/06/2020
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