Basic Information
Provider Information
NPI: 1972767671
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LWIN
FirstName: KYAW
MiddleName: MYO
NamePrefix: DR.
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 40 FRENCH ST
Address2: # 27
City: QUINCY
State: MA
PostalCode: 021713037
CountryCode: US
TelephoneNumber: 6178695294
FaxNumber:  
Practice Location
Address1: 2100 DORCHESTER AVE
Address2:  
City: DORCHESTER CENTER
State: MA
PostalCode: 021245615
CountryCode: US
TelephoneNumber: 6172964000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/11/2008
LastUpdateDate: 07/11/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X236995MAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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