Provider Demographics
NPI:1649518713
Name:NYUNT, MYO (MSC)
Entity type:Individual
Prefix:MR
First Name:MYO
Middle Name:
Last Name:NYUNT
Suffix:
Gender:M
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 CALIFORNIA AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-3011
Mailing Address - Country:US
Mailing Address - Phone:651-793-4906
Mailing Address - Fax:
Practice Address - Street 1:521 CALIFORNIA AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-3011
Practice Address - Country:US
Practice Address - Phone:651-793-4906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNF836060858517OtherDRIVER LICENSE