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General NPI Number Information
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NPI Number | 1407870389
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Entity Type | Individual
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Provider Name | MARY C. CHANG D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 600 PRIMROSE ST STE 202
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City | HAVERHILL
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State | MA
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Zip | 01830-2659
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Country | US
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Telephone | 978-556-1000
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Fax | 978-556-0094
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Provider Business Mailing Address
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Address Line | 24 MORRILL PL STE 2
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City | AMESBURY
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State | MA
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Zip | 01913-3530
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Country | US
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Telephone | 978-834-8074
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Fax | 978-834-8077
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | K1390
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 243524
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License Number State | MA
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