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General NPI Number Information
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NPI Number | 1467632679
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Entity Type | Organization
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Legal Business Name | M AWAD MD PA
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 8395 W OAKLAND PARK BLVD SUITE B
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City | SUNRISE
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State | FL
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Zip | 33351-7301
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Country | US
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Telephone | 954-578-2258
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Fax |
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Provider Business Mailing Address
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Address Line | 8395 W OAKLAND PARK BLVD SUITE B
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City | SUNRISE
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State | FL
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Zip | 33351-7301
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Country | US
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Telephone | 954-578-2258
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MEDHAT AHMED AWAD
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Credential | MD
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Telephone | 954-578-2256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME70194
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License Number State | FL
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