Individual
MOE M MYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 213, ABINGDON, VA 24211-7664
(276) 258-2600
(276) 258-2611
Mailing address
16000 JOHNSTON MEMORIAL DR, SUITE 213, ABINGDON, VA 24211-7664
(276) 258-2600
(276) 258-2611
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101253967
VA
207R00000X
Internal Medicine Physician
26227
OK
207R00000X
Internal Medicine Physician
44767
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104930502
—
VA
Enumeration date
08/19/2006
Last updated
02/21/2017
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