Healthcare Provider Details

I. General information

NPI: 1780186593
Provider Name (Legal Business Name): JUNG-UN CHOI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 03/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GH604 - 820 SHERBROOK
WINNIPEG MANITOBA
R3A 1R9
CA

IV. Provider business mailing address

#2111 - 72 DONALD STREET
WINNIPEG MANITOBA
317
CA

V. Phone/Fax

Practice location:
  • Phone: 204-952-3077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: