Provider Demographics
NPI:1730390717
Name:CHO, GRACE SHIN (MD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:SHIN
Last Name:CHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 FEDERAL STREET
Mailing Address - Street 2:SUITE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4935
Mailing Address - Fax:
Practice Address - Street 1:900 CENTENNIAL BLVD BLDG 2
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4637
Practice Address - Country:US
Practice Address - Phone:856-325-6770
Practice Address - Fax:856-673-4300
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2015-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06438000208D00000X
NJMA06438000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice