Provider Demographics
NPI:1770522476
Name:CHANG, MARGARET Y (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:Y
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 1:88 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-5520
Mailing Address - Country:US
Mailing Address - Phone:678-242-9102
Mailing Address - Fax:
Practice Address - Street 1:88 JOHNSON RD BLDG 2
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-5520
Practice Address - Country:US
Practice Address - Phone:404-369-1907
Practice Address - Fax:404-369-1970
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA81245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD130061000Medicaid
MD774803500Medicaid
MD130061000Medicaid
H39441Medicare UPIN