Healthcare Provider Details

I. General information

NPI: 1043140759
Provider Name (Legal Business Name): CAMERON CHOONG-SHIK PRICE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SAM PERRY BLVD STE 200
FREDERICKSBURG VA
22401-8420
US

IV. Provider business mailing address

1340 CENTRAL PARK BLVD STE 100
FREDERICKSBURG VA
22401-4940
US

V. Phone/Fax

Practice location:
  • Phone: 540-373-4602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110012001
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: