MEDICARE: MS. AMIE C CHANG P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	2005031799	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000097382	OTHER	MO	MEDICARE LEGACY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	218233	OTHER		BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1366557209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMIE C CHANG P.A.

Provider Business Mailing Address
First Line	:	11525 OLDE CABIN RD
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-7146
Country	:	US
Telephone Number	:	314-997-0554
Fax Number	:	314-997-5086

Provider Business Practice Location Address
First Line	:	11525 OLDE CABIN RD
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-7146
Country	:	US
Telephone Number	:	314-997-0554
Fax Number	:	314-997-5086

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	02/27/2014

Similar Medicare Providers

1003310822 — SOUMOJIT GHOSH MD
Practice Location Address:

11525 OLDE CABIN RD
CREVE COEUR, MO
63141-7146

Practice Phone: 314-997-0554
Practice Fax: 314-997-5086

1831180272 — ADVANCED ENDOSCOPY CENTER LLC
Practice Location Address:

11525 OLDE CABIN ROAD , SUITE 101
CREVE COEUR, MO
63141-7146

Practice Phone: 314-400-9999
Practice Fax: 314-400-9990

1447266432 — JANET TODORCZUK MD
Practice Location Address:

11525 OLDE CABIN RD
CREVE COEUR, MO
63141-7146

Practice Phone: 314-997-0554
Practice Fax: 314-997-5086

1467566703 — LEONARD B WEINSTOCK MD
Practice Location Address:

11525 OLDE CABIN RD
CREVE COEUR, MO
63141-7146

Practice Phone: 314-997-0554
Practice Fax: 314-997-5086

1669523270 — SPECIALIST IN GASTROENTEROLOGY
Practice Location Address:

11525 OLDE CABIN RD
CREVE COEUR, MO
63141-7146

Practice Phone: 314-997-0554
Practice Fax: 314-997-5086

1780228155 — OLDE CABIN ANESTHESIA
Practice Location Address:

11525 OLDE CABIN RD STE 101
CREVE COEUR, MO
63141-7146

Practice Phone: 314-400-9999
Practice Fax:

Directions to “ MS. AMIE C CHANG P.A.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.