Healthcare Provider Details

I. General information

NPI: 1487440236
Provider Name (Legal Business Name): PETER AWAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SUNNSYIDE ROAD
SMYRNA DE
19977
US

IV. Provider business mailing address

100 SUNNYSIDE RD
SMYRNA DE
19977-1752
US

V. Phone/Fax

Practice location:
  • Phone: 302-223-1370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0005427
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: