Healthcare Provider Details

I. General information

NPI: 1740245182
Provider Name (Legal Business Name): AHMED M AWAD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL RD STE 208
KANSAS CITY MO
64111-5941
US

IV. Provider business mailing address

4320 WORNALL RD STE 208
KANSAS CITY MO
64111-5941
US

V. Phone/Fax

Practice location:
  • Phone: 816-531-0552
  • Fax: 816-756-2503
Mailing address:
  • Phone: 816-531-0552
  • Fax: 816-756-2503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number106043
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: