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BOONCHOO CHANG M.D. P.C. NPI 1225158868


NPI Information

NPI: 1225158868
Provider Name: BOONCHOO CHANG M.D., P.C.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
417 W HIGH ST
DOWAGIAC, MI
ZIP 49047
Phone: (269) 782-7150
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BOONCHOO CHANG M.D., P.C. is a clinic center in Dowagiac, MI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). BOONCHOO CHANG M.D., P.C. NPI is 1225158868. The provider is registered as an organization entity type.

The provider's business location address is:

417 W HIGH ST
DOWAGIAC, MI
ZIP 49047-906
Phone: (269) 782-7150
Fax: (269) 782-7020

The provider's authorized official is Boonchoo Chang .
The authorized official title is President and has the following contact phone number (269) 782-7150.

The enumeration date for this NPI number is 3/29/2007 and was last updated on 12/20/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterBC031400MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
123-3905MEDICARE ID-TYPE UNSPECIFIEDMICHIGANRURAL HEALTH MEDICARE
2E21165MEDICARE UPINMICHIGAN
31093701MEDICAIDMICHIGAN
40141181MEDICARE ID-TYPE UNSPECIFIEDMICHIGANMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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