Healthcare Provider Details

I. General information

NPI: 1730186370
Provider Name (Legal Business Name): STEVE HWAN-SOO CHOI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 BRANDT PIKE
DAYTON OH
45424
US

IV. Provider business mailing address

6210 BRANDT PIKE
DAYTON OH
45424
US

V. Phone/Fax

Practice location:
  • Phone: 937-236-8630
  • Fax: 937-236-8635
Mailing address:
  • Phone: 937-236-8630
  • Fax: 937-236-8635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number84111
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: