Healthcare Provider Details

I. General information

NPI: 1942998109
Provider Name (Legal Business Name): SUNG HWAN CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date: 11/29/2023
Reactivation Date: 01/02/2024

III. Provider practice location address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

IV. Provider business mailing address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

V. Phone/Fax

Practice location:
  • Phone: 617-919-2900
  • Fax: 617-730-0254
Mailing address:
  • Phone: 617-919-2900
  • Fax: 617-730-0254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number1026710
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: