Healthcare Provider Details

I. General information

NPI: 1003293879
Provider Name (Legal Business Name): ANNA EUNJOO CHOE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 11/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 N WOLFE ST RM WB602
BALTIMORE MD
21205
US

IV. Provider business mailing address

615 N WOLFE ST RM WB602
BALTIMORE MD
21205-2103
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-3362
  • Fax: 410-614-1582
Mailing address:
  • Phone: 410-955-3362
  • Fax: 410-614-1582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0085463
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: