Provider Demographics
NPI:1245223619
Name:CHANG, WILLIAM WEI-JUNG (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WEI-JUNG
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WEI-JUNG
Other - Middle Name:WILLIAM
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:770 W HIGH ST STE 160
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-5900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:770 W HIGH ST STE 160
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-5900
Practice Address - Country:US
Practice Address - Phone:419-996-5224
Practice Address - Fax:419-996-5276
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5079208100000X
NY188561208100000X, 225400000X
OH35-092684208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3013198Medicaid
OH3013198Medicaid
NY02113784Medicare PIN
NYG04339Medicare UPIN
OH4284111Medicare PIN