Basic Information
| Provider Information | |||||||||
| NPI: | 1568972115 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHANG | ||||||||
| FirstName: | ALDEN | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9105 FRANKLIN SQUARE DR STE 209 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212373958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4436059954 | ||||||||
| FaxNumber: | 4103913343 | ||||||||
| Practice Location | |||||||||
| Address1: | 9105 FRANKLIN SQUARE DR STE 209 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212373958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105741330 | ||||||||
| FaxNumber: | 4103913343 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2017 | ||||||||
| LastUpdateDate: | 05/28/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | C006643 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.