Healthcare Provider Details

I. General information

NPI: 1952301988
Provider Name (Legal Business Name): ZAHID F AWAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 02/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S 5TH ST
READING PA
19602-1662
US

IV. Provider business mailing address

200 NORTH 7TH STREET
LEBANON PA
17046
US

V. Phone/Fax

Practice location:
  • Phone: 610-685-2188
  • Fax: 610-685-2187
Mailing address:
  • Phone: 717-273-1710
  • Fax: 717-273-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD058260-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: