Provider Demographics
NPI:1336467521
Name:OH, CHRISTOPHER CHAEYUL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CHAEYUL
Last Name:OH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 3157
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3157
Mailing Address - Country:US
Mailing Address - Phone:855-871-1526
Mailing Address - Fax:855-277-8543
Practice Address - Street 1:790 CHURCH ST NE
Practice Address - Street 2:STE 400
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7282
Practice Address - Country:US
Practice Address - Phone:770-952-8899
Practice Address - Fax:678-581-3680
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0751012085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program