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NPI Code Detail

MEDICARE: KAU-WUN CHANG MD

MEDICARE: KAU-WUN 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
1207P00000XEmergency Medicine Physician35040164OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1942460636905OTHEROHCARESOURCE

General Provider Information

NPI Number : 1780624379
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAU-WUN CHANG MD
Provider Business Mailing Address
First Line : 347 FRONT ST
Second Line :
City : BEREA
State : OH
Zip : 44017-1771
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18697 BAGLEY RD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-3417
Country : US
Telephone Number : 440-816-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 07/08/2007

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