Provider Demographics
NPI:1558592204
Name:CHO, JULIE EUNYOUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:EUNYOUNG
Last Name:CHO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8815-A BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043
Mailing Address - Country:US
Mailing Address - Phone:410-461-8606
Mailing Address - Fax:410-461-8604
Practice Address - Street 1:8815 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4154
Practice Address - Country:US
Practice Address - Phone:410-461-8606
Practice Address - Fax:410-461-8604
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1255152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD137M072FMedicare PIN
MD181262YAXGMedicare PIN
MDU75554Medicare UPIN