Healthcare Provider Details

I. General information

NPI: 1316491533
Provider Name (Legal Business Name): ZAW WIN PHYO M.B,B.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SENTARA CIR RM 2C
WILLIAMSBURG VA
23188-5713
US

IV. Provider business mailing address

1300 FRANKLIN AVE STE 380
NORMAL IL
61761-4266
US

V. Phone/Fax

Practice location:
  • Phone: 757-984-7217
  • Fax:
Mailing address:
  • Phone: 309-268-3598
  • Fax: 309-268-2536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.148955
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101289411
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: