Chul Chang, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

CC043583 Issued in MI

Practice address

400 Medical Park Dr
Watervliet, MI 49098-9225

Phone

(269) 463-2449

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital Primary Care - Coloma

  • Rural Health Clinic/Center
  • Coloma, MI
  • NPI 1083710701
  NPD (past)
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital

  • Rural Health Clinic/Center
  • Dowagiac, MI
  • NPI 1184467607
  NPD (past)
• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospitals

  • Rural Health Clinic/Center
  • Watervliet, MI
  • NPI 1508924770
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1194760157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MEDICAL PARK DR",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490988531",
            "telephone_number": "269-463-6900",
            "fax_number": "269-463-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989225",
            "telephone_number": "269-463-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CHUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "CC043583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - BANGOR",
            "identifier": "0M55810",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2589390",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3208317",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELDOFMI",
            "identifier": "1101102151",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BANGOR",
            "identifier": "110H010030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Bendewald
• Sabina J Bett, NP
• Bio-Medical Applications of Michigan, Inc. (Fresenius Medical Care Watervliet)
• Deborah Ann Breen, PA
• Donald F. Brooks, M.D.
• Community Hospital
• Community Hospital
• Community Hospital (Bangor Medical Center)
• Jonathon Andrew Covyeou, PHARM D
• Andrew A Dehaven, D.C.

• Specialist in Watervliet, MI
• Providers in Watervliet, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.