Healthcare Provider Details

I. General information

NPI: 1013290576
Provider Name (Legal Business Name): DR. BOYUN CHOI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 S MAIN ST
ALPHARETTA GA
30009-1993
US

IV. Provider business mailing address

173 S MAIN ST
ALPHARETTA GA
30009-1993
US

V. Phone/Fax

Practice location:
  • Phone: 678-297-9178
  • Fax: 678-297-9412
Mailing address:
  • Phone: 678-297-9178
  • Fax: 678-297-9412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS44896
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH025685
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: