Provider Demographics
NPI:1417246463
Name:CHOI, JUNG EUN (DC)
Entity Type:Individual
Prefix:
First Name:JUNG EUN
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7049 OLD COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1728
Mailing Address - Country:US
Mailing Address - Phone:703-953-6555
Mailing Address - Fax:
Practice Address - Street 1:481 N FREDERICK AVE STE 230
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2471
Practice Address - Country:US
Practice Address - Phone:301-527-1510
Practice Address - Fax:301-527-9320
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03757111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD765342OtherOPTUM HEALTH
VA765342OtherUNITED HEALTHCARE
VAK218-0018OtherCAREFIRST BLUE CROSS BLUE SHIELD