Provider Demographics
NPI:1740256254
Name:CHANG, JOHN SHYUE-YI (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SHYUE-YI
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 1:112 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-4406
Mailing Address - Country:US
Mailing Address - Phone:704-732-3346
Mailing Address - Fax:704-732-6863
Practice Address - Street 1:112 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4406
Practice Address - Country:US
Practice Address - Phone:704-732-3346
Practice Address - Fax:704-732-6863
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22464207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8922010Medicaid
NCE14226Medicare UPIN
NC205363AMedicare ID - Type Unspecified