Provider Demographics
NPI:1063432318
Name:CHANG, KU-LANG (MD)
Entity type:Individual
Prefix:DR
First Name:KU-LANG
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KU-LANG
Other - Middle Name:
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:623 N 35TH ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3126
Mailing Address - Country:US
Mailing Address - Phone:252-222-5700
Mailing Address - Fax:252-222-5705
Practice Address - Street 1:623 N 35TH ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3126
Practice Address - Country:US
Practice Address - Phone:252-222-5700
Practice Address - Fax:252-222-5705
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61744207Q00000X
NC2021-03351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373183900Medicaid
F61432Medicare UPIN