Provider Demographics
NPI:1558564161
Name:THEIN, KHIN KYAW KYAW (MD, MS)
Entity Type:Individual
Prefix:
First Name:KHIN
Middle Name:KYAW KYAW
Last Name:THEIN
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 PUDDLEDOCK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23875-1268
Mailing Address - Country:US
Mailing Address - Phone:804-526-1111
Mailing Address - Fax:804-526-2978
Practice Address - Street 1:4700 PUDDLEDOCK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23875-1268
Practice Address - Country:US
Practice Address - Phone:804-526-1111
Practice Address - Fax:804-526-2978
Is Sole Proprietor?:No
Enumeration Date:2007-06-10
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101244050207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine