Provider Demographics
NPI:1376592485
Name:CHOE, YEONIL (MD)
Entity Type:Individual
Prefix:DR
First Name:YEONIL
Middle Name:
Last Name:CHOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 FOX HILL ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:680 CENTRE ST
Practice Address - Street 2:ANESTHETICS OF BROCKTON, PC
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3308
Practice Address - Country:US
Practice Address - Phone:508-941-7656
Practice Address - Fax:508-941-6345
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37658207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA96199601OtherNETWORK HEALTH
MAP00266817OtherRAILROAD
MA202010504OtherUHC
MA2697OtherHPHC
MA10926OtherNHP
FM1376592485OtherBMC
MA1053836OtherFALLON
MA3070662Medicaid
MA4458224OtherAETNA
MA2609808002OtherCIGNA
MA795245OtherTUFTS
MAJ10589OtherBCBS
MAP00266817OtherRAILROAD
MA2697OtherHPHC
MA4458224OtherAETNA