Individual
THEODORE JOHN CHOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 VIRGINIA AVE, COLUMBIA, MO 65212-0001
(573) 882-2663
(573) 882-5847
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2006006302
MO
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
2006006302
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200757409
—
MO
01
—
204960
BLUE SHIELD
MO
01
—
739111
HEALTHLINK
MO
Enumeration date
05/31/2006
Last updated
10/05/2022
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