Provider Demographics
NPI:1669639019
Name:SAN HO CHOI, M.D., P.A.
Entity Type:Organization
Organization Name:SAN HO CHOI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAN HO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-369-4240
Mailing Address - Street 1:56 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2632
Mailing Address - Country:US
Mailing Address - Phone:828-369-4240
Mailing Address - Fax:828-369-4440
Practice Address - Street 1:56 MEDICAL PARK DR
Practice Address - Street 2:SUITE 202
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2632
Practice Address - Country:US
Practice Address - Phone:828-369-4240
Practice Address - Fax:828-369-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18249208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8922455Medicaid
NC201405OtherMEDICARE
NC22455OtherBLUE CROSS/BLUE SHIELD