| Jack Chang Md Pc | |
|
706 Rogers St Lowell MA 01852-4338 | |
| (978) 937-9333 | |
| (978) 937-9992 |
| Full Name | Jack Chang Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 706 Rogers St, Lowell, Massachusetts |
| Authorized Official Name and Position | Jack Chang (MD) |
| Authorized Official Contact | 9789379333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Chang Md Pc 706 Rogers St Lowell MA 01852-4338 Ph: (978) 937-9333 | Jack Chang Md Pc 706 Rogers St Lowell MA 01852-4338 Ph: (978) 937-9333 |
| NPI Number | 1235114216 |
|---|---|
| Provider Enumeration Date | 12/13/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1658532437 |
|---|---|
| Medicare Enrollment ID | O20120423000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235114216 | NPI | - | NPPES |
| 9782567 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 74694 (Massachusetts) | Primary |
| Provider Name | Jack C Chang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811182041 PECOS PAC ID: 8022106335 Enrollment ID: I20071121000037 |
| Provider Name | Mary Elizabeth Trahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053994558 PECOS PAC ID: 3971994823 Enrollment ID: I20220103001483 |
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