Healthcare Provider Details

I. General information

NPI: 1861998148
Provider Name (Legal Business Name): JOSHUA SUNCHUL CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: J. S. CHOI MD

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 10/22/2023
Certification Date: 10/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 ESKENAZI AVE
INDIANAPOLIS IN
46202-5187
US

IV. Provider business mailing address

1101 W 10TH ST
INDIANAPOLIS IN
46202-4800
US

V. Phone/Fax

Practice location:
  • Phone: 317-880-0000
  • Fax:
Mailing address:
  • Phone: 317-274-9450
  • Fax: 317-274-9305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01086072A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: