Provider Demographics
NPI:1285677104
Name:CHANG, WAYNE WEI-YUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:WEI-YUAN
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 1:3715 LATIMERS KNOLL CT STE 103
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7361
Mailing Address - Country:US
Mailing Address - Phone:540-357-7101
Mailing Address - Fax:540-361-1874
Practice Address - Street 1:3715 LATIMERS KNOLL CT STE 103
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7361
Practice Address - Country:US
Practice Address - Phone:540-357-7101
Practice Address - Fax:540-361-1874
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012260402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010229898Medicaid
VA463978OtherVALUE OPTIONS
VA085153MOtherOPTIMA HEALTH
VA2099799OtherCIGNA
VA2134184OtherALLIANCE PPO
VA085153MOtherOPTIMA HEALTH
VA008170C11Medicare ID - Type Unspecified