MEDICARE: DR. SUNG-RAN CHO 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	2084P0800X	Psychiatry Physician	4301032129	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260638180	OTHER	MI	BCBS OF MI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497796379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUNG-RAN CHO M.D.

Provider Business Mailing Address
First Line	:	20905 GREENFIELD RD
Second Line	:	#305
City	:	SOUTHFIELD
State	:	MI
Zip	:	48075-5360
Country	:	US
Telephone Number	:	248-552-8110
Fax Number	:

Provider Business Practice Location Address
First Line	:	22170 W 9 MILE RD
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-6007
Country	:	US
Telephone Number	:	248-372-6800
Fax Number	:

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/01/2022

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