Basic Information
| Provider Information | |||||||||
| NPI: | 1164461257 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHANG | ||||||||
| FirstName: | YU-WEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | STE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178516969 | ||||||||
| Practice Location | |||||||||
| Address1: | 147 GETTYS ST | ||||||||
| Address2: | |||||||||
| City: | GETTYSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173252534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173374120 | ||||||||
| FaxNumber: | 7173374236 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 11/20/2007 | ||||||||
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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 | 207ZP0102X | MD050306L | PA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 101004 | 01 | PA | GEISINGER-GH | OTHER | 125647 | 01 | PA | UNISON-GH | OTHER | 1521172 | 01 | PA | GATEWAY-GH | OTHER | 0175910000 | 01 | PA | AMERIHEALTH 65 PA-GH | OTHER | 139060 | 01 | PA | HIGHMARK BLUE SHIELD-GH | OTHER | 20016168 | 01 | PA | AMERIHEALTH MERCY-GH | OTHER | 50067141 | 01 | PA | CAPITAL BLUE CROSS-GH | OTHER |