Provider Demographics
NPI:1154501294
Name:CHANG, STEVE WON-TZE (MD)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:WON-TZE
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4434
Mailing Address - Country:US
Mailing Address - Phone:602-406-3112
Mailing Address - Fax:602-406-4187
Practice Address - Street 1:1875 W FRYE RD STE 300
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6184
Practice Address - Country:US
Practice Address - Phone:602-406-3112
Practice Address - Fax:602-406-4187
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42069207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ434630Medicaid
AZ434630Medicaid