Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | D41129 | MD |
NPI | 1154371797 |
---|---|
Provider Name | Dr. Peter W Cho |
First Address | Baltimore, MD 21215-5216 |
Second Address | Baltimore, MD 21215-5224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 21/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CA8374 | R/R MEDICARE GROUP # (01) | MD |
G71394 | (02) | MD |
P00235139 | R/R MEDICARE PROVIDER # (01) | MD |