Provider Demographics
NPI:1669455861
Name:THAUNG, MEHM T (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHM
Middle Name:T
Last Name:THAUNG
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:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:252-744-3253
Mailing Address - Fax:252-744-3194
Practice Address - Street 1:CHOWAN MEDICAL CENTER
Practice Address - Street 2:201 VIRGINIA ROAD
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932
Practice Address - Country:US
Practice Address - Phone:252-482-2116
Practice Address - Fax:252-482-6274
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201633208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00002730OtherRAILROAD MEDICARE
NC89133EYMedicaid
NC133EYOtherBCBS NC
NCP00002730OtherRAILROAD MEDICARE
NC89133EYMedicaid