Provider Demographics
NPI:1528744711
Name:CHI, KELVIN CHO
Entity type:Individual
Prefix:
First Name:KELVIN
Middle Name:CHO
Last Name:CHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 WOODHILL DR APT E
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-6724
Mailing Address - Country:US
Mailing Address - Phone:609-635-6171
Mailing Address - Fax:
Practice Address - Street 1:233 WOODHILL DR APT E
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-6724
Practice Address - Country:US
Practice Address - Phone:609-635-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator