Basic Information
| Provider Information | |||||||||
| NPI: | 1235373648 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHANG | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6355 WALKER LN STE 300 | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 223103247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037976980 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8501 ARLINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220314617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039706464 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2009 | ||||||||
| LastUpdateDate: | 10/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 0101259063 | VA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.