Provider Demographics
NPI:1053358382
Name:AUNG, MA THUZAR (MD)
Entity type:Individual
Prefix:DR
First Name:MA
Middle Name:THUZAR
Last Name:AUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10250 SE 167TH PLACE RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8682
Mailing Address - Country:US
Mailing Address - Phone:352-735-3755
Mailing Address - Fax:352-735-3151
Practice Address - Street 1:10250 SE 167TH PLACE RD
Practice Address - Street 2:SUITE 5-1
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8682
Practice Address - Country:US
Practice Address - Phone:352-735-3755
Practice Address - Fax:352-735-3151
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94470207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME94470OtherMEDICAL LICENSE
FL275587400Medicaid