MEDICARE: MICHAEL CHOI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	14558	NC

General Provider Information

NPI Number	:	1750082269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CHOI

Provider Business Mailing Address
First Line	:	3809 FORRESTGATE DR STE A
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2982
Country	:	US
Telephone Number	:	336-768-9010
Fax Number	:

Provider Business Practice Location Address
First Line	:	3809 FORRESTGATE DR # 5
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2982
Country	:	US
Telephone Number	:	336-768-9010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	02/25/2026

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