Provider Demographics
NPI:1235359050
Name:SCHUBERT, MOONKYUNG CHO (MD)
Entity Type:Individual
Prefix:DR
First Name:MOONKYUNG
Middle Name:CHO
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MOON
Other - Middle Name:KYUNG
Other - Last Name:CHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:302 PUMP HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5177
Mailing Address - Country:US
Mailing Address - Phone:423-833-5850
Mailing Address - Fax:
Practice Address - Street 1:660 BANNOCK ST FL 3
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4506
Practice Address - Country:US
Practice Address - Phone:303-602-6195
Practice Address - Fax:303-602-6190
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 109162207RG0100X
WI82226207RG0100X
CODR.0070206207RG0100X
WAMD60470855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003640800Medicaid