Provider Demographics
NPI:1376543652
Name:WIN, MAUNG KYAW (MD)
Entity type:Individual
Prefix:DR
First Name:MAUNG
Middle Name:KYAW
Last Name:WIN
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 1:1600 CLOISTER DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2390
Mailing Address - Country:US
Mailing Address - Phone:717-391-7092
Mailing Address - Fax:717-431-2321
Practice Address - Street 1:2031 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603
Practice Address - Country:US
Practice Address - Phone:717-397-2738
Practice Address - Fax:717-397-7634
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423779207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012414780002Medicaid
PAP006591OtherGATEWAY HEALTH PLAN
PAH78076OtherHEALTH AMERICA
PAP00320446OtherRAILROAD MEDICARE
PA107757 S1QAOtherGEISINGER HEALTH PLAN
PA1725658OtherHIGHMARK BLUE SHIELD
PA1902868466OtherCBC
PA1725658OtherHIGHMARK BLUE SHIELD
PAP006591OtherGATEWAY HEALTH PLAN