Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ki-Eun Chang, MD

Individual provider Neurological Surgery Physician · NPI 1073979332

Dr. Ki-Eun Chang, MD is a Neurosurgery in Providence, Rhode Island. Qualified in 2015, 11 years ago. Practices as a sole proprietor. Licensed in California and Rhode Island.

Years since qualifying
11
Licensed in
CA, RI
In the registry since
2016
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

593 Eddy Street Apc 6
Providence, RI 02903-4923
Phone: (401) 793-9166
Fax: (401) 444-2788
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence MD18382 (RI)
Neurological Surgery Physician Taxonomy 207T00000X · Licence A147705 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1073979332
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 2, 2016
Last updated in NPPESMay 25, 2022
Certification dateMay 9, 2022
Mailing address117 Ellenfield St Ste 101, Providence, RI 02905-4541

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROSURGERY
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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