Provider Demographics
NPI:1174691562
Name:CHOI, ROSAN Y (MD)
Entity type:Individual
Prefix:DR
First Name:ROSAN
Middle Name:Y
Last Name:CHOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:PPQA MEDICARE COMPLIANCE UNIT 6 WEST
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:6501 LOISDALE COURT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1885
Practice Address - Country:US
Practice Address - Phone:703-922-1407
Practice Address - Fax:703-922-1111
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054685207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC010729M92Medicare UPIN
010729M92Medicare ID - Type Unspecified
G95701Medicare UPIN