MEDICARE: MYINT M THWAY MD

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	207R00000X	Internal Medicine Physician	ME104024	FL
2	207RR0500X	Rheumatology Physician	ME104024	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568600575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYINT M THWAY MD

Provider Business Mailing Address
First Line	:	PO BOX 746638
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6638
Country	:	US
Telephone Number	:	904-202-2092
Fax Number	:	904-376-4075

Provider Business Practice Location Address
First Line	:	13241 BARTRAM PARK BLVD UNIT 2105
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5224
Country	:	US
Telephone Number	:	904-292-4111
Fax Number	:	904-292-4080

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

Provider Enumeration Date	:	01/29/2009
Last Update Date	:	01/28/2025

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Directions to “ MYINT M THWAY MD” Practice Location

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