Provider Demographics
NPI:1093771024
Name:NWE, MYO M (MD)
Entity Type:Individual
Prefix:
First Name:MYO
Middle Name:M
Last Name:NWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 ARDEN LN
Mailing Address - Street 2:#100
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3286
Mailing Address - Country:US
Mailing Address - Phone:803-325-2236
Mailing Address - Fax:803-325-2234
Practice Address - Street 1:744 ARDEN LN
Practice Address - Street 2:#100
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3286
Practice Address - Country:US
Practice Address - Phone:803-325-2236
Practice Address - Fax:803-325-2234
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC23841207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4541Medicaid
SCH86882Medicare UPIN
SCGP4541Medicaid