Provider Demographics
NPI:1245358985
Name:CHANG, AGNES JU (MD, FAAD)
Entity type:Individual
Prefix:DR
First Name:AGNES
Middle Name:JU
Last Name:CHANG
Suffix:
Gender:F
Credentials:MD, FAAD
Other - Prefix:
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Mailing Address - Street 1:2141 K ST NW
Mailing Address - Street 2:STE 307
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1810
Mailing Address - Country:US
Mailing Address - Phone:202-293-3990
Mailing Address - Fax:202-496-9103
Practice Address - Street 1:2141 K ST NW
Practice Address - Street 2:STE 307
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1810
Practice Address - Country:US
Practice Address - Phone:202-293-3990
Practice Address - Fax:202-496-9103
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD037509207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology