Provider Demographics
NPI:1235137514
Name:CHANG, HAO (MD)
Entity Type:Individual
Prefix:
First Name:HAO
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 1:25 OAKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26261-1150
Mailing Address - Country:US
Mailing Address - Phone:304-846-2608
Mailing Address - Fax:304-846-2608
Practice Address - Street 1:25 OAKFORD AVE
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:WV
Practice Address - Zip Code:26261-1150
Practice Address - Country:US
Practice Address - Phone:304-846-2608
Practice Address - Fax:304-846-2608
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV9980208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVCH0400551Medicare ID - Type Unspecified
C34945Medicare UPIN