Provider Demographics
NPI:1790877207
Name:CHUNG CHO, MI HEI HEI (MD)
Entity Type:Individual
Prefix:DR
First Name:MI HEI
Middle Name:HEI
Last Name:CHUNG CHO
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 1:8301 ARLINGTON BLVD. #401
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:703-645-0606
Mailing Address - Fax:703-207-9273
Practice Address - Street 1:8301 ARLINGTON BLVD #401
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:703-645-0606
Practice Address - Fax:703-207-9273
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048770208000000X
VA0101253646208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200340280Medicaid
ING97908Medicare UPIN