Provider Demographics
NPI:1225368517
Name:BO ZAW-WIN, M.D.,P.A.
Entity Type:Organization
Organization Name:BO ZAW-WIN, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAW-WIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-391-7200
Mailing Address - Street 1:6830 HOSPITAL DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4375
Mailing Address - Country:US
Mailing Address - Phone:410-391-7200
Mailing Address - Fax:410-391-7210
Practice Address - Street 1:6830 HOSPITAL DR
Practice Address - Street 2:SUITE 104
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4375
Practice Address - Country:US
Practice Address - Phone:410-391-7200
Practice Address - Fax:410-391-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD016728207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD185411900Medicaid
B69868Medicare UPIN
170335Medicare PIN