Individual
CHI WAN KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(917) 538-1156
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
54710
MN
2085R0202X
Diagnostic Radiology Physician
MT193796
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/17/2008
Last updated
08/14/2020
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