Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 13240 | WV |
NPI | 1013014620 |
---|---|
Provider Name | Chang Hyuk Choi |
First Address | Charleston, WV 25314-1160 |
Second Address | Charleston, WV 25314-1160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2006 |
Last Update Date | 26/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0070730000 | (05) | WV |
E27192 | (02) |