Healthcare Provider Details

I. General information

NPI: 1871026823
Provider Name (Legal Business Name): AHMED J AWAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 STATE ST
ERIE PA
16550-2200
US

IV. Provider business mailing address

120 E 2ND ST STE 401
ERIE PA
16507-1577
US

V. Phone/Fax

Practice location:
  • Phone: 814-877-7310
  • Fax:
Mailing address:
  • Phone: 814-877-7310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD488312
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA193315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: