Individual
DR. MIRA CHOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3850 S NATIONAL AVE, #700, SPRINGFIELD, MO 65807-5287
(417) 269-0700
(417) 269-0709
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-0700
(417) 269-0709
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
103527
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106523
BLUE CROSS
—
05
—
208614503
—
MO
Enumeration date
08/15/2006
Last updated
12/04/2012
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