Basic Information
Provider Information
NPI: 1093780447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHO
FirstName: CHARLES
MiddleName: H.
NamePrefix: DR.
NameSuffix:  
Credential: D.O..
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 758963
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212758963
CountryCode: US
TelephoneNumber: 8049685700
FaxNumber: 8042177991
Practice Location
Address1: 601 POTOMAC STATION DR NE
Address2:  
City: LEESBURG
State: VA
PostalCode: 201761816
CountryCode: US
TelephoneNumber: 7038401396
FaxNumber: 7038401397
Other Information
ProviderEnumerationDate: 02/21/2006
LastUpdateDate: 03/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X0102201637VAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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