Provider Demographics
NPI:1871373407
Name:CHOI, HYUNWOO (PA)
Entity type:Individual
Prefix:
First Name:HYUNWOO
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:525 FRIARS HEAD DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7654
Mailing Address - Country:US
Mailing Address - Phone:404-388-3171
Mailing Address - Fax:
Practice Address - Street 1:771 OLD NORCROSS RD STE 105
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4977
Practice Address - Country:US
Practice Address - Phone:770-509-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant