Provider Demographics
NPI:1083725717
Name:MAW, KHIN THET (MD)
Entity Type:Individual
Prefix:DR
First Name:KHIN
Middle Name:THET
Last Name:MAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6208 HOMESPUN LN
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-1012
Mailing Address - Country:US
Mailing Address - Phone:703-216-1421
Mailing Address - Fax:
Practice Address - Street 1:8119 HOLLAND RD
Practice Address - Street 2:GARTLAN MOUNT VERNON
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1912
Practice Address - Country:US
Practice Address - Phone:703-216-1421
Practice Address - Fax:703-782-1593
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABM01010409582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945026Medicaid
VAG43234Medicare UPIN