Healthcare Provider Details

I. General information

NPI: 1255404547
Provider Name (Legal Business Name): SING YE REBECCA CHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 01/07/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 PEACHTREE ST NE SUITE C-08
ATLANTA GA
30303-1701
US

IV. Provider business mailing address

3495 PIEDMONT RD NE
ATLANTA GA
30305-1717
US

V. Phone/Fax

Practice location:
  • Phone: 404-589-3630
  • Fax: 770-439-5501
Mailing address:
  • Phone: 404-364-7285
  • Fax: 404-364-4869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number054599
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: