Provider Demographics
NPI:1760471049
Name:CHOE, KYURAN ANN (MD)
Entity Type:Individual
Prefix:
First Name:KYURAN
Middle Name:ANN
Last Name:CHOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636256 CENTRAL CREDENTIALING
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-245-3107
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-1000
Practice Address - Country:US
Practice Address - Phone:513-584-4391
Practice Address - Fax:513-584-0431
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0666392085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64937014Medicaid
OH1601039OtherUNITED HEALTHCARE
OH0991048Medicaid
OH300042099OtherRAILROAD MEDICARE
WV1802966000Medicaid
GA250138947AMedicaid
OH652341OtherAETNA
IN200038830AMedicaid
SCQ66639Medicaid
OH652341OtherAETNA
OH1601039OtherUNITED HEALTHCARE