Provider Demographics
NPI:1720246853
Name:MON, KYAW SOE (MD)
Entity Type:Individual
Prefix:DR
First Name:KYAW
Middle Name:SOE
Last Name:MON
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 1:27 FARNHAM WAY
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-7438
Mailing Address - Country:US
Mailing Address - Phone:410-252-3605
Mailing Address - Fax:
Practice Address - Street 1:600 NORTH WOLFE STREET
Practice Address - Street 2:BLALOCK 1410
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-4963
Practice Address - Country:US
Practice Address - Phone:410-955-7615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0072884207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology