MEDICARE: DR. JOHN CHUN-LU CHANG MD

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	207Y00000X	Otolaryngology Physician	MD425419	PA
2	207YP0228X	Pediatric Otolaryngology Physician	MD425419	PA
3	207YS0123X	Facial Plastic Surgery Physician	MD425419	PA
4	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	MD425419	PA
5	207YX0901X	Otology & Neurotology Physician	MD425419	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
18	867633	OTHER	PA	MEDICARE GROUP #
20	P00222626	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	120420405	OTHER	PA	DEPT OF LABOR
2	161083	OTHER	PA	UNISON
3	2138338	OTHER	PA	FIRST HEALTH
4	25-1716306	OTHER	PA	INTERGROUP
5	1544525	OTHER	PA	GATEWAY
6	25-1716306	OTHER	PA	MULTIPLAN/PHCS
7	426713	OTHER	PA	HEALTH AMERICA
8	G920-0039/647200-02	OTHER	PA	CAREFIRST
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	2129690	OTHER	PA	MAMSI
11	25-1716306	OTHER	PA	INFORMED
12	25-1716306	OTHER	PA	SOUTH CENTRAL PREFERRED
13	25-1716306	OTHER	PA	HEALTHNET/TRICARE
14	MD425419	OTHER	PA	LICENSE
15	25-1716306	OTHER	PA	DEVON
16	25-1716306	OTHER	PA	GREATWEST
17	50044493	OTHER	PA	CAPITAL BLUECROSS
19	3698774	OTHER	PA	AETNA HMO
21	7615333	OTHER	PA	AETNA NON-HMO
22	CH1658644	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1427053370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CHUN-LU CHANG MD

Provider Business Mailing Address
First Line	:	785 5TH AVENUE
Second Line	:	SUITE 3
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-4232
Country	:	US
Telephone Number	:	717-263-9555
Fax Number	:	717-217-4218

Provider Business Practice Location Address
First Line	:	757 NORLAND AVENUE
Second Line	:	SUITE 203
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-4231
Country	:	US
Telephone Number	:	717-217-6870
Fax Number	:	717-217-6945

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	03/07/2023

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