Basic Information
| Provider Information | |||||||||
| NPI: | 1184935934 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHOI | ||||||||
| FirstName: | ERWIN | ||||||||
| MiddleName: | JINHO | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 529 TERRY REILEY WAY | ||||||||
| Address2: | |||||||||
| City: | POTTSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 179011774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706244444 | ||||||||
| FaxNumber: | 5706244447 | ||||||||
| Practice Location | |||||||||
| Address1: | 529 TERRY REILEY WAY | ||||||||
| Address2: | |||||||||
| City: | POTTSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 179011774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706244444 | ||||||||
| FaxNumber: | 5706244447 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2010 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 266955 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS016491 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.