Provider Demographics
NPI:1811007057
Name:CHOI, SOONJA PARK (MD)
Entity Type:Individual
Prefix:DR
First Name:SOONJA
Middle Name:PARK
Last Name:CHOI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:COL SOONJA P CHOI MD
Mailing Address - Street 2:HHC 121 GENERAL HOSPITAL BOX 232
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-5244
Mailing Address - Country:US
Mailing Address - Phone:011822-749-7068
Mailing Address - Fax:1815-366-7557
Practice Address - Street 1:COL SOONJA P CHOI MD
Practice Address - Street 2:HHC 121 GENERAL HOSPITAL BOX 232
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-5244
Practice Address - Country:US
Practice Address - Phone:01194315-725-6232
Practice Address - Fax:1815-366-7557
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-08-17
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Provider Licenses
StateLicense IDTaxonomies
NJMA043717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ581183OtherAETNA US HEALTHCARE
NJ1068173OtherMERCY
NJ569752OtherAMERIHEALTH
NJ0195707Medicaid
NJMA043717Medicare ID - Type Unspecified
NJ0195707Medicaid