Provider Demographics
NPI:1114187549
Name:XIA, CHANG (MD)
Entity Type:Individual
Prefix:
First Name:CHANG
Middle Name:
Last Name:XIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5308 HARROUN RD
Mailing Address - Street 2:SUITE 055
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2193
Mailing Address - Country:US
Mailing Address - Phone:419-824-6599
Mailing Address - Fax:419-882-3870
Practice Address - Street 1:5308 HARROUN RD
Practice Address - Street 2:SUITE 055
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2193
Practice Address - Country:US
Practice Address - Phone:419-824-6599
Practice Address - Fax:419-882-3870
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35123481207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0103198Medicaid
OHH314110Medicare PIN