MEDICARE: KHIN MYET THWE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4351049272	MI
2	207Q00000X	Family Medicine Physician	P112949	NY
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1134885825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHIN MYET THWE

Provider Business Mailing Address
First Line	:	2147 BELCOURT AVE STE 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-3516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2147 BELCOURT AVE STE 100
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-3516
Country	:	US
Telephone Number	:	929-317-3715
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2021
Last Update Date	:	07/03/2025

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Directions to “ KHIN MYET THWE ” Practice Location

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