Individual
MS. SAMANTHA L CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1850A TOWN CENTER PKWY # 1, SUITE 209, RESTON, VA 20190-5851
(703) 437-5532
Mailing address
1850A TOWN CENTER PKWY # 1, SUITE 209, RESTON, VA 20190-5851
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110005056
VA
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110005056
VIRGINIA PA LISCENSE
VA
01
—
PA9107537
PHYSICIAN ASSISTANT LICENSE
FL
Enumeration date
09/25/2013
Last updated
11/27/2023
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