Provider Demographics
NPI:1205119377
Name:CHANG, GEORGE Y (PHARMACIST)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:Y
Last Name:CHANG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11160 VEIRS MILL RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2538
Mailing Address - Country:US
Mailing Address - Phone:301-692-1331
Mailing Address - Fax:301-692-1332
Practice Address - Street 1:11160 VEIRS MILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902
Practice Address - Country:US
Practice Address - Phone:301-692-1331
Practice Address - Fax:301-692-1332
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10026183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist