Provider Demographics
NPI:1023091683
Name:CHO, NAMI L (MD)
Entity type:Individual
Prefix:
First Name:NAMI
Middle Name:L
Last Name:CHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W SCHROCK RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8702
Mailing Address - Country:US
Mailing Address - Phone:614-882-0708
Mailing Address - Fax:614-882-2878
Practice Address - Street 1:555 W SCHROCK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8702
Practice Address - Country:US
Practice Address - Phone:614-882-0708
Practice Address - Fax:614-882-2878
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.073485207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2117757Medicaid
OH0878171Medicare PIN
OH2117757Medicaid