Provider Demographics
NPI:1285639740
Name:CHANG, PAUL S (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:CHANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:21 HIGHLAND AVE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3872
Mailing Address - Country:US
Mailing Address - Phone:978-462-7555
Mailing Address - Fax:978-462-9049
Practice Address - Street 1:21 HIGHLAND AVE
Practice Address - Street 2:SUITE 16
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3872
Practice Address - Country:US
Practice Address - Phone:978-462-7555
Practice Address - Fax:978-462-9049
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2010-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA243728207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A0262Medicaid
TXH72567Medicare UPIN
TX8A0262Medicaid