Provider Demographics
NPI:1619981875
Name:CHANG, DAVID KEYDAI (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KEYDAI
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 1:1616 WESTGATE CIR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8019
Mailing Address - Country:US
Mailing Address - Phone:615-844-6234
Mailing Address - Fax:615-844-6235
Practice Address - Street 1:1616 WESTGATE CIR
Practice Address - Street 2:SUITE 210
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8019
Practice Address - Country:US
Practice Address - Phone:615-844-6234
Practice Address - Fax:615-844-6235
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN265412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG53661Medicare UPIN
TN3813933Medicare ID - Type Unspecified