Provider Demographics
NPI:1588850879
Name:LWIN, TIN MAY
Entity Type:Individual
Prefix:
First Name:TIN
Middle Name:MAY
Last Name:LWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIN
Other - Middle Name:MAY
Other - Last Name:LWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4747 W 31ST PL
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7424
Mailing Address - Country:US
Mailing Address - Phone:630-864-0001
Mailing Address - Fax:
Practice Address - Street 1:2400 S AVE A
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7127
Practice Address - Country:US
Practice Address - Phone:928-336-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125050612207R00000X
AZ41676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine