Healthcare Provider Details

I. General information

NPI: 1881824712
Provider Name (Legal Business Name): AWAD EL-ASHRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 COLVIN BLVD
BUFFALO NY
14223-1440
US

IV. Provider business mailing address

PO BOX 2839
MERIDIAN MS
39302-2839
US

V. Phone/Fax

Practice location:
  • Phone: 716-874-4060
  • Fax:
Mailing address:
  • Phone: 601-703-3480
  • Fax: 601-703-0124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number24253
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: