Provider Demographics
NPI:1730186370
Name:CHOI, STEVE HWAN-SOO (MD)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:HWAN-SOO
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 BRANDT PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424
Mailing Address - Country:US
Mailing Address - Phone:937-236-8630
Mailing Address - Fax:937-236-8635
Practice Address - Street 1:6210 BRANDT PIKE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424
Practice Address - Country:US
Practice Address - Phone:937-236-8630
Practice Address - Fax:937-236-8635
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH84111207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2511455Medicaid
WV3810026164Medicaid
OH2511455Medicaid
OHH111910Medicare PIN
OHI09992Medicare UPIN