Healthcare Provider Details

I. General information

NPI: 1124223771
Provider Name (Legal Business Name): ESTHER I-PING CHANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 CORPORATE BLVD SUITE 210
NORFOLK VA
23502-4975
US

IV. Provider business mailing address

241 CORPORATE BLVD STE 210
NORFOLK VA
23502-4965
US

V. Phone/Fax

Practice location:
  • Phone: 757-622-2200
  • Fax: 757-965-9493
Mailing address:
  • Phone: 757-622-2200
  • Fax: 757-622-4866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101250445
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: