Provider Demographics
NPI:1578514873
Name:OAK, CHANG Y (MD)
Entity Type:Individual
Prefix:
First Name:CHANG
Middle Name:Y
Last Name:OAK
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:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-0707
Mailing Address - Country:US
Mailing Address - Phone:252-793-4135
Mailing Address - Fax:252-793-1530
Practice Address - Street 1:1006 US HIGHWAY 64 E
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-9216
Practice Address - Country:US
Practice Address - Phone:252-793-7701
Practice Address - Fax:252-793-7736
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26966207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine