Provider Demographics
NPI:1861674848
Name:CHOI, MICHELLE Y (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:Y
Last Name:CHOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S 12TH ST
Mailing Address - Street 2:APT. 307S
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5556
Mailing Address - Country:US
Mailing Address - Phone:917-374-8454
Mailing Address - Fax:
Practice Address - Street 1:221 S 12TH ST
Practice Address - Street 2:APT. 307S
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5556
Practice Address - Country:US
Practice Address - Phone:917-374-8454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT188620207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine