Provider Demographics
NPI:1417251257
Name:PREMIER ORTHOPAEDIC BONE & JOINT CARE
Entity Type:Organization
Organization Name:PREMIER ORTHOPAEDIC BONE & JOINT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:CHOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-241-7336
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-0607
Mailing Address - Country:US
Mailing Address - Phone:302-241-7336
Mailing Address - Fax:302-752-7020
Practice Address - Street 1:329 MULLET RUN
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-5373
Practice Address - Country:US
Practice Address - Phone:302-424-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0004819207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG04089Medicare UPIN