Provider Demographics
NPI:1619943792
Name:TIN, THAN ZAW WIN (MD)
Entity Type:Individual
Prefix:
First Name:THAN ZAW
Middle Name:WIN
Last Name:TIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 COMMERCE WAY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6325
Mailing Address - Country:US
Mailing Address - Phone:615-465-7000
Mailing Address - Fax:
Practice Address - Street 1:2305 CHAMBLISS AVE NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3847
Practice Address - Country:US
Practice Address - Phone:423-559-6000
Practice Address - Fax:423-559-6653
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA870588111BMedicaid
TN4134490OtherBCBS
GA870588111AMedicaid
TN7054406OtherCIGNA
TN3890226Medicaid
GA870588111CMedicaid
GA870588111BMedicaid
TN3890226Medicaid