Provider Demographics
NPI:1669576377
Name:CHOE, ERIC JW (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JW
Last Name:CHOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JONG
Other - Middle Name:W
Other - Last Name:CHOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2826 OLD LEE HWY
Mailing Address - Street 2:#300
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4323
Mailing Address - Country:US
Mailing Address - Phone:703-273-9393
Mailing Address - Fax:703-273-7928
Practice Address - Street 1:2826 OLD LEE HWY
Practice Address - Street 2:#300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4323
Practice Address - Country:US
Practice Address - Phone:703-273-9393
Practice Address - Fax:703-273-7928
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047728208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010272998Medicaid
G02282N07OtherPIN #
G02282N07OtherPIN #
VA010272998Medicaid