Provider Demographics
NPI:1184661878
Name:CHANG, JAMES DUCKSOON (MD)
Entity Type:Individual
Prefix:
First Name:JAMES DUCKSOON
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 1:82 OTIS ST
Mailing Address - Street 2:APT #3
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1719
Mailing Address - Country:US
Mailing Address - Phone:617-667-2680
Mailing Address - Fax:
Practice Address - Street 1:330 BROOKLINE AVENUE
Practice Address - Street 2:BETH ISRAEL HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-632-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73888207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease