1376653881 NPI number — CHO MYA MON WIN M.D.

Table of content: (NPI 1568626083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376653881 NPI number — CHO MYA MON WIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WIN
Provider First Name:
CHO MYA MON
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376653881
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4638 SUN N LAKE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEBRING
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33872-2176
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
863-386-0055
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4638 SUN N LAKE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEBRING
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33872-2176
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-386-0055
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD429620 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: MD429620 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: ME111988 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 34936 . This is a "HEALTH PARTNERS FF" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1900834 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 34935 . This is a "HEALTH PARTNERS TC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1900834 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 34937 . This is a "HEALTH PARTNERS FB" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1017561000002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2767675000 . This is a "KEYSTONE, IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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