Provider Demographics
NPI:1598365538
Name:CHOI, HYUNG WOOK (PHARM D)
Entity Type:Individual
Prefix:
First Name:HYUNG
Middle Name:WOOK
Last Name:CHOI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:1414 RUFFNER LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-8197
Mailing Address - Country:US
Mailing Address - Phone:678-833-7700
Mailing Address - Fax:
Practice Address - Street 1:300 S BELAIR RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-9337
Practice Address - Country:US
Practice Address - Phone:706-941-5927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031697183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist