Healthcare Provider Details

I. General information

NPI: 1578557500
Provider Name (Legal Business Name): ERIC ADRIAN AWAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 PEACHTREE RD NE SUITE 333
ATLANTA GA
30309-1407
US

IV. Provider business mailing address

2045 PEACHTREE RD NE SUITE 333
ATLANTA GA
30309-1407
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-8804
  • Fax: 404-355-1022
Mailing address:
  • Phone: 404-355-8804
  • Fax: 404-355-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35203
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: