Provider Demographics
NPI:1629064605
Name:CHANG, NORMAN ANYI (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:ANYI
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 JEFFERSON DAVIS HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8402
Mailing Address - Country:US
Mailing Address - Phone:540-371-4141
Mailing Address - Fax:540-371-1990
Practice Address - Street 1:611 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8402
Practice Address - Country:US
Practice Address - Phone:540-371-4141
Practice Address - Fax:540-371-1990
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA110007257Medicare PIN
VAP21655Medicare UPIN