Provider Demographics
NPI:1265651848
Name:MYO THANT M.D., P.A.
Entity Type:Organization
Organization Name:MYO THANT M.D., P.A.
Other - Org Name:PET IMAGING CENTER AT HARFORD COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MYO
Authorized Official - Middle Name:
Authorized Official - Last Name:THANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-836-7119
Mailing Address - Street 1:9114 PHILADELPHIA RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4317
Mailing Address - Country:US
Mailing Address - Phone:410-687-5300
Mailing Address - Fax:410-682-4418
Practice Address - Street 1:602 S ATWOOD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4172
Practice Address - Country:US
Practice Address - Phone:410-836-7119
Practice Address - Fax:410-836-8179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDFMN006Medicare ID - Type Unspecified