Healthcare Provider Details

I. General information

NPI: 1073649422
Provider Name (Legal Business Name): CALYA MYINT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 E ST #14 SE
WASHINGTON DC
20003
US

IV. Provider business mailing address

8430 BRIAR CREEK DRIVE
ANNANDALE VA
22003
US

V. Phone/Fax

Practice location:
  • Phone: 202-673-9319
  • Fax: 202-698-3171
Mailing address:
  • Phone: 703-272-8355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD33822
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101233384
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: