Healthcare Provider Details

I. General information

NPI: 1588850879
Provider Name (Legal Business Name): TIN MAY LWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TIN MAY LWIN M.D.

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S AVE A
YUMA AZ
85364-7127
US

IV. Provider business mailing address

4747 W 31ST PL
YUMA AZ
85364-7424
US

V. Phone/Fax

Practice location:
  • Phone: 928-336-1441
  • Fax:
Mailing address:
  • Phone: 630-864-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125050612
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number41676
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: