Provider Demographics
NPI:1942398870
Name:ZAW WIN, BO (MD)
Entity type:Individual
Prefix:DR
First Name:BO
Middle Name:
Last Name:ZAW WIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BO
Other - Middle Name:
Other - Last Name:ZAW-WIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD,PA
Mailing Address - Street 1:6830 HOSPITAL DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4373
Mailing Address - Country:US
Mailing Address - Phone:410-391-7200
Mailing Address - Fax:410-391-7210
Practice Address - Street 1:785 ELKRIDGE LANDING RD STE 300
Practice Address - Street 2:
Practice Address - City:LINTHICUM HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21090-2958
Practice Address - Country:US
Practice Address - Phone:443-323-3014
Practice Address - Fax:855-212-5249
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD016728207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD185411900Medicaid
MD9517Medicare PIN
MD185411900Medicaid