Basic Information
| Provider Information | |||||||||
| NPI: | 1245358985 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHANG | ||||||||
| FirstName: | AGNES | ||||||||
| MiddleName: | JU | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., F.A.A.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2141 K ST NW | ||||||||
| Address2: | STE 307 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200371810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022933990 | ||||||||
| FaxNumber: | 2024969103 | ||||||||
| Practice Location | |||||||||
| Address1: | 2141 K ST NW | ||||||||
| Address2: | STE 307 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200371810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022933990 | ||||||||
| FaxNumber: | 2024969103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2007 | ||||||||
| LastUpdateDate: | 03/17/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | MD037509 | DC | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.