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General NPI Number Information
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NPI Number | 1548581044
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Entity Type | Organization
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Legal Business Name | AWAD MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 1717 HIGH ST SUITE 3C
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-6300
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Country | US
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Telephone | 270-632-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 HIGH ST SUITE 3C
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-6300
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Country | US
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Telephone | 270-632-4565
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. MOHAMED S AWAD
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Credential | MD
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Telephone | 270-632-4565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 43384
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License Number State | KY
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