Healthcare Provider Details

I. General information

NPI: 1023057445
Provider Name (Legal Business Name): MYUNG W CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 BROAD BRANCH CT
MC LEAN VA
22101-2140
US

IV. Provider business mailing address

1021 BROAD BRANCH CT
MC LEAN VA
22101-2140
US

V. Phone/Fax

Practice location:
  • Phone: 571-425-0660
  • Fax:
Mailing address:
  • Phone: 571-425-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101055262
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME175128
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: