MEDICARE: ANNIE MYOWIN CHANG-BURNS M.D.

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	207R00000X	Internal Medicine Physician	29424	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29424	OTHER	AZ	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427048008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE MYOWIN CHANG-BURNS M.D.

Provider Business Mailing Address
First Line	:	1739 E BEVERLY AVE
Second Line	:	SUITE 201
City	:	KINGMAN
State	:	AZ
Zip	:	86409-3593
Country	:	US
Telephone Number	:	928-692-3456
Fax Number	:	928-692-7071

Provider Business Practice Location Address
First Line	:	1739 E BEVERLY AVE
Second Line	:	SUITE 201
City	:	KINGMAN
State	:	AZ
Zip	:	86409-3593
Country	:	US
Telephone Number	:	928-692-3456
Fax Number	:	928-692-7071

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	03/07/2023

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