Provider Demographics
NPI:1699385054
Name:CHOI, JEONGMIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEONGMIN
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5559 GLENRIDGE DR APT 2202
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-7206
Mailing Address - Country:US
Mailing Address - Phone:404-844-3372
Mailing Address - Fax:
Practice Address - Street 1:104 TOWN BLVD NE # A100
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3146
Practice Address - Country:US
Practice Address - Phone:404-233-7480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist