Provider Demographics
NPI:1205978731
Name:CHANG, FELICIA (MD)
Entity type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
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 37326
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27627-7326
Mailing Address - Country:US
Mailing Address - Phone:336-460-4306
Mailing Address - Fax:
Practice Address - Street 1:1507 N ROAD ST STE 2
Practice Address - Street 2:SENTARA INTERNAL MEDICINE
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3283
Practice Address - Country:US
Practice Address - Phone:336-460-4306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine