Provider Demographics
NPI:1427053370
Name:CHANG, JOHN CHUN-LU (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHUN-LU
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:757 NORLAND AVENUE
Practice Address - Street 2:SUITE 203
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4231
Practice Address - Country:US
Practice Address - Phone:717-217-6870
Practice Address - Fax:717-217-6945
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425419207Y00000X, 207YP0228X, 207YS0123X, 207YX0007X, 207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA120420405OtherDEPT OF LABOR
PA161083OtherUNISON
PA2138338OtherFIRST HEALTH
PA25-1716306OtherINTERGROUP
PA1544525OtherGATEWAY
PA25-1716306OtherMULTIPLAN/PHCS
PA426713OtherHEALTH AMERICA
PAG920-0039/647200-02OtherCAREFIRST
PA101236084 0001Medicaid
PA2129690OtherMAMSI
PA25-1716306OtherINFORMED
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA25-1716306OtherHEALTHNET/TRICARE
PAMD425419OtherLICENSE
PA25-1716306OtherDEVON
PA25-1716306OtherGREATWEST
PA50044493OtherCAPITAL BLUECROSS
PA867633OtherMEDICARE GROUP #
PA3698774OtherAETNA HMO
PAP00222626OtherRAILROAD MEDICARE
PA7615333OtherAETNA NON-HMO
PACH1658644OtherHIGHMARK BLUE SHIELD
PACH1658644OtherHIGHMARK BLUE SHIELD
PA867633OtherMEDICARE GROUP #
PAP00222626OtherRAILROAD MEDICARE