Healthcare Provider Details
I. General information
NPI: 1114210226
Provider Name (Legal Business Name): KHINE SWE ZIN MIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/23/2011
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7TH AND CLAYTON STREETS
WILMINGTON DE
19805-3155
US
IV. Provider business mailing address
7 PRESIDENTIAL DR APT D
WILMINGTON DE
19807-3218
US
V. Phone/Fax
- Phone: 302-575-8040
- Fax:
- Phone: 312-852-5175
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | ME132790 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | ME132790 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | ME132790 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | C1-0011076 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: