MEDICARE: JOHN Y CHOI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MD00046238	WA
2	207W00000X	Ophthalmology Physician	D66433	MD

General Provider Information

NPI Number	:	1114981149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN Y CHOI M.D.

Provider Business Mailing Address
First Line	:	3460 OLD WASHINGTON RD STE 101
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3241
Country	:	US
Telephone Number	:	301-893-3484
Fax Number	:	301-893-3481

Provider Business Practice Location Address
First Line	:	3460 OLD WASHINGTON RD STE 101
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3241
Country	:	US
Telephone Number	:	301-893-3484
Fax Number	:	301-893-3481

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	11/22/2022

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