MEDICARE: MR. KHAI SHENG 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	207R00000X	Internal Medicine Physician	ME75650	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881665222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KHAI SHENG CHANG MD

Provider Business Mailing Address
First Line	:	10250 SE 167TH PLACE RD UNIT 5
Second Line	:
City	:	SUMMERFIELD
State	:	FL
Zip	:	34491-8682
Country	:	US
Telephone Number	:	352-307-9225
Fax Number	:	352-307-8442

Provider Business Practice Location Address
First Line	:	18550 US HIGHWAY 441
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-6725
Country	:	US
Telephone Number	:	352-735-3755
Fax Number	:	352-735-3151

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	01/11/2018

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