Provider Demographics
NPI:1124013545
Name:THANT, MYO (MD)
Entity Type:Individual
Prefix:DR
First Name:MYO
Middle Name:
Last Name:THANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1000 WESTWICKE LN
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3706
Mailing Address - Country:US
Mailing Address - Phone:410-687-5300
Mailing Address - Fax:410-682-4418
Practice Address - Street 1:9114 PHILADELPHIA RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4317
Practice Address - Country:US
Practice Address - Phone:410-687-5300
Practice Address - Fax:410-682-4418
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0018487207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD102315OtherAETNA
MD530001100Medicaid
830005807OtherMEDICARE RAILROAD
MD530001100Medicaid
830005807OtherMEDICARE RAILROAD