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General NPI Number Information
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NPI Number | 1528287836
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Entity Type | Individual
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Provider Name | GWEN CAROLINE CHOI MD
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 2750 LAUREL ST STE 103
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City | COLUMBIA
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State | SC
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Zip | 29204-2023
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Country | US
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Telephone | 803-865-4934
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 23321
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City | NEW YORK
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State | NY
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Zip | 10087-4321
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 35.090806
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 40151
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4301109296
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MD40151
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License Number State | SC
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