Healthcare Provider Details

I. General information

NPI: 1659878841
Provider Name (Legal Business Name): JEFFREY HYUN-KYU CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WEALTHY ST SE STE 300
GRAND RAPIDS MI
49506-2969
US

IV. Provider business mailing address

100 MICHIGAN ST NE # MC845
GRAND RAPIDS MI
49503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 616-774-8345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number4301510989
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: