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General NPI Number Information
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NPI Number | 1609178144
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Entity Type | Individual
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Provider Name | CHARLES BONGSIK CHOE PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 960 NEWMAN RD
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City | NEW BERN
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State | NC
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Zip | 28562-5200
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Country | US
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Telephone | 252-633-6730
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Fax | 252-633-6740
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Provider Business Mailing Address
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Address Line | PO BOX 896206
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City | CHARLOTTE
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State | NC
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Zip | 28289-6206
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Country | US
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Telephone | 252-633-6730
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Fax | 252-633-6740
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-03774
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License Number State | NC
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