Provider Demographics
NPI:1174841100
Name:HEALTH CHOICE GROUP PC
Entity Type:Organization
Organization Name:HEALTH CHOICE GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHONG
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-790-1003
Mailing Address - Street 1:2030 LOCHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-3919
Mailing Address - Country:US
Mailing Address - Phone:248-937-0212
Mailing Address - Fax:248-366-4510
Practice Address - Street 1:2030 LOCHAVEN RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48324-3919
Practice Address - Country:US
Practice Address - Phone:248-937-0212
Practice Address - Fax:248-366-4510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1174841100Medicaid
MI1174841100Medicaid