Healthcare Provider Details

I. General information

NPI: 1700253473
Provider Name (Legal Business Name): PETER CHOYKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2015
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MOLECULAR IMAGING PROGRAM NCI BUILDING 10, ROOM B3B69F
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

MOLECULAR IMAGING PROGRAM NCI BUILDING 10, ROOM B3B69F
BETHESDA MD
20892-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-402-8409
  • Fax: 301-402-3191
Mailing address:
  • Phone: 301-402-8409
  • Fax: 301-402-3191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0033794
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: