Healthcare Provider Details

I. General information

NPI: 1912907593
Provider Name (Legal Business Name): CHANG B. CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 05/20/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MEDICAL PKWY
ANNAPOLIS MD
21401-3280
US

IV. Provider business mailing address

PO BOX 64916
BALTIMORE MD
21264-4916
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-1000
  • Fax:
Mailing address:
  • Phone: 410-216-6481
  • Fax: 410-280-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0061783
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101262334
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: