Provider Demographics
NPI:1588683676
Name:CHO, CHINSOO LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINSOO
Middle Name:LAWRENCE
Last Name:CHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE, MMC 494
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-6146
Mailing Address - Fax:612-624-5445
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:500 HARVARD STREET SE
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-273-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN476322085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0596007Medicaid
MN2366350OtherARAZ
MNB630OtherCHAMPUS
MN158436700Medicaid
MNHP52803OtherHEALTHPARTNERS
MN132900OtherUCARE
MN1044125OtherPREFERRED ONE
WI34666200Medicaid
MT0144432Medicaid
MN24-02006OtherMEDICA PRIMARY
MN24-00190OtherMEDICA CHOICE
MN617T6CHOtherBCBS
WI34666200Medicaid
MNHP52803OtherHEALTHPARTNERS
MN158436700Medicaid