MEDICARE: MR. EDWARD EUN CHO SCM

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	2086X0206X	Surgical Oncology Physician	38551	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8HD252	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1336453406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD EUN CHO SCM

Provider Business Mailing Address
First Line	:	PO BOX 268838
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73126-8838
Country	:	US
Telephone Number	:	918-619-4400
Fax Number	:	918-634-7560

Provider Business Practice Location Address
First Line	:	1919 S WHEELING AVE STE 600
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-5635
Country	:	US
Telephone Number	:	918-619-4400
Fax Number	:	918-634-7560

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

Provider Enumeration Date	:	08/01/2010
Last Update Date	:	11/01/2021

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