Boonchoo Chang, M.D.
Individual provider Active NPI Geriatric Medicine (Internal Medicine) Physician · Dowagiac, MI
NPI 1609932417 · NPPES record last updated Dec 28, 2007
Key facts
- NPI
- 1609932417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician 207RG0300X
- License
- 4301031400 (MI)
- Practice address
- 417 W High St
Dowagiac, MI 49047-1906 - Phone
- (269) 782-7150
- Fax
- (269) 782-7020
- NPI assigned
- Dec 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalamazoo Emergency Associates, PLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 4301031400 | MI | |
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 4301031400 | MI | Yes |
Addresses
Primary practice location
417 W High St
Dowagiac, MI 49047-1906
Mailing address
417 W High St
Dowagiac, MI 49047-1906
Phone (269) 782-7150
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093701 | Medicaid | MI |
Other providers in Dowagiac, MI
- Mary Buck
- Alexander Burau
- Charles Kenneth Burling
- Linda Strickler Campbell
- Eric J Chamberlin
- Shanta Lynn Clark
- Michelle Marie Cockey
- Delphine Colar
- Comfort Living Home L.L.C. #3
- Community Care of Dowagiac, PLLC
All providers in Dowagiac, MI · Geriatric Medicine (Internal Medicine) Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.