Provider Demographics
NPI:1477625192
Name:CHOO-CHOI, EUN SOOK (MD)
Entity type:Individual
Prefix:MS
First Name:EUN
Middle Name:SOOK
Last Name:CHOO-CHOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:EUN
Other - Middle Name:SOOK
Other - Last Name:CHOO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:12632 DEXTER AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-3340
Mailing Address - Country:US
Mailing Address - Phone:313-868-7700
Mailing Address - Fax:313-868-0303
Practice Address - Street 1:12632 DEXTER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-3340
Practice Address - Country:US
Practice Address - Phone:313-868-7700
Practice Address - Fax:313-868-0303
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033498208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301033498OtherMI STATE LICENCE NUMBER
MI20OtherPEDIATRIC
MIDEA 5973068OtherDEA NUMVER