Provider Demographics
NPI:1164461257
Name:CHANG, YU-WEN (MD)
Entity Type:Individual
Prefix:
First Name:YU-WEN
Middle Name:
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 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:STE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:147 GETTYS ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2534
Practice Address - Country:US
Practice Address - Phone:717-337-4120
Practice Address - Fax:717-337-4236
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050306L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101004OtherGEISINGER-GH
PA125647OtherUNISON-GH
PA1521172OtherGATEWAY-GH
PA0175910000OtherAMERIHEALTH 65 PA-GH
PA139060OtherHIGHMARK BLUE SHIELD-GH
PA20016168OtherAMERIHEALTH MERCY-GH
PA50067141OtherCAPITAL BLUE CROSS-GH
PA139060OtherHIGHMARK BLUE SHIELD-GH
PA1521172OtherGATEWAY-GH