Healthcare Provider Details

I. General information

NPI: 1164503504
Provider Name (Legal Business Name): MIN HO CHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 ORCHARD VILLAS AVE
APEX NC
27502-4321
US

IV. Provider business mailing address

1545 ORCHARD VILLAS AVE
APEX NC
27502-4321
US

V. Phone/Fax

Practice location:
  • Phone: 919-576-8383
  • Fax:
Mailing address:
  • Phone: 919-576-8383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2014-00818
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: