Healthcare Provider Details

I. General information

NPI: 1558455451
Provider Name (Legal Business Name): HOWARD T. CHANG MD. PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E. MICHIGAN AVE. LOWER LEVEL
LANSING MI
48912
US

IV. Provider business mailing address

PO BOX 13008
LANSING MI
48901-3008
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-5258
  • Fax:
Mailing address:
  • Phone: 517-364-6253
  • Fax: 517-364-6208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License Number4301088774
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: