Healthcare Provider Details

I. General information

NPI: 1427053370
Provider Name (Legal Business Name): JOHN CHUN-LU CHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 NORLAND AVENUE SUITE 203
CHAMBERSBURG PA
17201-4231
US

IV. Provider business mailing address

785 5TH AVENUE SUITE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 717-217-6870
  • Fax: 717-217-6945
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-217-4218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD425419
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD425419
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberMD425419
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD425419
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberMD425419
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: