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General NPI Number Information
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NPI Number | 1578721593
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Entity Type | Individual
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Provider Name | STEPHEN W. CHANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 1980 GALLOWS RD
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City | VIENNA
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State | VA
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Zip | 22182-3913
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Country | US
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Telephone | 703-356-9899
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Fax |
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Provider Business Mailing Address
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Address Line | 1980 GALLOWS RD
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City | VIENNA
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State | VA
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Zip | 22182-3913
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Country | US
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Telephone |
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 246121
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 246121
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101242425
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA09064100
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License Number State | NJ
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