Provider Demographics
NPI:1922038207
Name:M. OHN MAUNG, MD, P.C.
Entity Type:Organization
Organization Name:M. OHN MAUNG, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:M.
Authorized Official - Middle Name:OHN
Authorized Official - Last Name:MAUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-899-2480
Mailing Address - Street 1:2216 PRINCESS ANNE ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3300
Mailing Address - Country:US
Mailing Address - Phone:540-899-2480
Mailing Address - Fax:540-899-2484
Practice Address - Street 1:2216 PRINCESS ANNE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3300
Practice Address - Country:US
Practice Address - Phone:540-899-2480
Practice Address - Fax:540-899-2484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V350M89Medicare PIN