Provider Demographics
NPI:1043868235
Name:CHOI, RYAN JUNHO (PHARMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JUNHO
Last Name:CHOI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11635 CAVALIER LANDING CT UNIT 202
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-8705
Mailing Address - Country:US
Mailing Address - Phone:804-386-6163
Mailing Address - Fax:
Practice Address - Street 1:8414 OLD KEENE MILL RD UNIT A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-2302
Practice Address - Country:US
Practice Address - Phone:703-913-6712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist