Healthcare Provider Details

I. General information

NPI: 1215003637
Provider Name (Legal Business Name): MYO THANT M.D.P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9114 PHILADELPHIA RD SUITE 208
BALTIMORE MD
21237-4317
US

IV. Provider business mailing address

9114 PHILADELPHIA RD SUITE 208
BALTIMORE MD
21237-4317
US

V. Phone/Fax

Practice location:
  • Phone: 410-687-5300
  • Fax: 410-682-4418
Mailing address:
  • Phone: 410-687-5300
  • Fax: 410-682-4418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MYO THANT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-687-5300