Provider Demographics
NPI:1073807954
Name:KAWAR, MAYYA
Entity Type:Individual
Prefix:
First Name:MAYYA
Middle Name:
Last Name:KAWAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:FREDERIKSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00841-1198
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:866-408-0381
Practice Address - Street 1:4100 SION FARM SHOPP CTR STE 5&6
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4433
Practice Address - Country:US
Practice Address - Phone:340-772-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA199486207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine