Healthcare Provider Details

I. General information

NPI: 1568667269
Provider Name (Legal Business Name): MARIE LINDA AWAD-ALEXANDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8423 MARKET ST STE 205
BOARDMAN OH
44512-6778
US

IV. Provider business mailing address

8423 MARKET ST STE 205
BOARDMAN OH
44512-6778
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-3125
  • Fax: 330-729-1861
Mailing address:
  • Phone: 330-729-3125
  • Fax: 330-729-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD445711
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.099370
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: