MEDICARE: MRS. MARYANN MIYUN CHOI I 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	K9039	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982673083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARYANN MIYUN CHOI I M.D.

Provider Business Mailing Address
First Line	:	1500 UNIVERSITY DR E STE 100
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77840-2600
Country	:	US
Telephone Number	:	979-383-2340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 UNIVERSITY DR E STE 100
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77840-2600
Country	:	US
Telephone Number	:	979-383-2340
Fax Number	:

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	03/06/2024

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