MEDICARE: GHULAM AWAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	13944-320	WI
2	207R00000X	Internal Medicine Physician	13944-320	WI
3	207R00000X	Internal Medicine Physician	036.177950	IL
4	207RC0000X	Cardiovascular Disease Physician	036.177950	IL
5	207RC0000X	Cardiovascular Disease Physician	21944	AL
6	207RC0000X	Cardiovascular Disease Physician	13944-320	WI
7	207RI0011X	Interventional Cardiology Physician	31605	MS
8	207RI0011X	Interventional Cardiology Physician	036.177950	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51500202	OTHER	AL	BCBS INTERNAL MED
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	51500205	OTHER	AL	BCBS KPG
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	51500203	OTHER	AL	BCBS SRC
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760431662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GHULAM AWAN MD

Provider Business Mailing Address
First Line	:	PO BOX 40480
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36640-0480
Country	:	US
Telephone Number	:	251-434-3626
Fax Number	:	251-445-2464

Provider Business Practice Location Address
First Line	:	2451 UNIVERSITY HOSPITAL DRIVE
Second Line	:	BLDG. C
City	:	MOBILE
State	:	AL
Zip	:	36617-2238
Country	:	US
Telephone Number	:	251-445-8242
Fax Number	:	251-445-8250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	04/08/2026

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