Provider Demographics
NPI:1568972115
Name:CHANG, ALDEN S (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ALDEN
Middle Name:S
Last Name:CHANG
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9105 FRANKLIN SQUARE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3958
Mailing Address - Country:US
Mailing Address - Phone:443-605-9954
Mailing Address - Fax:410-391-3343
Practice Address - Street 1:9105 FRANKLIN SQUARE DR STE 209
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3958
Practice Address - Country:US
Practice Address - Phone:410-574-1330
Practice Address - Fax:410-391-3343
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2019-05-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDC006643363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant