Individual
DR. JAI JONG CHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3046 BERKMAR DR, SUITE B, CHARLOTTESVILLE, VA 22901-1444
(434) 973-3356
(434) 973-2363
Mailing address
3046 BERKMAR DR, SUITE B, CHARLOTTESVILLE, VA 22901-1444
(434) 973-3356
(434) 973-2363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101034437
VA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
0101034437
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080000239
MEDICARE PTAN
VA
01
—
361921
ANTHEM BC-BS-MEDICARE EXTENDED SUPPLEMENT
VA
05
—
5628547
—
VA
Enumeration date
07/07/2006
Last updated
04/10/2009
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