Provider Demographics
NPI:1497735617
Name:CHO, M JEANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:M
Middle Name:JEANNETTE
Last Name:CHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1402 BOETTLER RD STE C
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-9584
Mailing Address - Country:US
Mailing Address - Phone:330-899-0103
Mailing Address - Fax:330-899-0268
Practice Address - Street 1:1402 BOETTLER RD STE C
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9584
Practice Address - Country:US
Practice Address - Phone:330-899-0103
Practice Address - Fax:330-899-0268
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-6006207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2461376Medicaid
G49753Medicare UPIN
OH2461376Medicaid