Provider Demographics
NPI:1457772998
Name:CHO, SANG K
Entity Type:Individual
Prefix:MR
First Name:SANG
Middle Name:K
Last Name:CHO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 EVERGREEN LN
Mailing Address - Street 2:STE M
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3238
Mailing Address - Country:US
Mailing Address - Phone:703-642-1234
Mailing Address - Fax:
Practice Address - Street 1:4330 EVERGREEN LN
Practice Address - Street 2:STE M
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3238
Practice Address - Country:US
Practice Address - Phone:703-642-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000123171100000X
MDU00358171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist