Provider Demographics
NPI:1992402127
Name:PATRICK CHANG
Entity type:Organization
Organization Name:PATRICK CHANG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:GLAD
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-919-2212
Mailing Address - Street 1:2235 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5412
Mailing Address - Country:US
Mailing Address - Phone:810-919-2212
Mailing Address - Fax:810-733-7677
Practice Address - Street 1:3807 WOODMONTE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48306-4798
Practice Address - Country:US
Practice Address - Phone:248-404-7716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty