Provider Demographics
NPI:1669521548
Name:WIN, AYE M (MD)
Entity type:Individual
Prefix:MRS
First Name:AYE
Middle Name:M
Last Name:WIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 W ROSS BLVD
Mailing Address - Street 2:STE 2A
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-7217
Mailing Address - Country:US
Mailing Address - Phone:620-227-3141
Mailing Address - Fax:620-227-8095
Practice Address - Street 1:100 W ROSS BLVD
Practice Address - Street 2:STE 2A
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-7217
Practice Address - Country:US
Practice Address - Phone:620-227-3141
Practice Address - Fax:866-607-8603
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0420644207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100148360AMedicaid
B69260Medicare UPIN
2050461601WMedicare ID - Type Unspecified