Basic Information
| Provider Information | |||||||||
| NPI: | 1346603909 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHOI | ||||||||
| FirstName: | JONATHAN | ||||||||
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| OtherLastName: | CHOI | ||||||||
| OtherFirstName: | SEUNGBEOM | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 30055 NORTHWESTERN HWY STE 101 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483343260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488654444 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 30055 NORTHWESTERN HWY STE 101 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483343260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488654444 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2016 | ||||||||
| LastUpdateDate: | 07/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YX0901X | 43510477327 | MI | Y | Allopathic & Osteopathic Physicians | Otolaryngology | Otology & Neurotology |
No ID Information.