Provider Demographics
NPI:1912034471
Name:CHANG, I-WEN (MD)
Entity Type:Individual
Prefix:DR
First Name:I-WEN
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:631 PROFESSIONAL DR STE 450
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3370
Mailing Address - Country:US
Mailing Address - Phone:770-963-8030
Mailing Address - Fax:678-533-1575
Practice Address - Street 1:631 PROFESSIONAL DR STE 450
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3370
Practice Address - Country:US
Practice Address - Phone:770-963-8030
Practice Address - Fax:770-339-9577
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200300757207RH0003X
GA079105207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology