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General NPI Number Information
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NPI Number | 1720039043
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Entity Type | Individual
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Provider Name | MOHAMMED I AWAAD MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 1104 BROAD AVE
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City | GULFPORT
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State | MS
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Zip | 39501-2414
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Country | US
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Telephone | 228-388-6500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 399
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City | LONG BEACH
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State | MS
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Zip | 39560-0399
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Country | US
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Telephone | 228-343-4057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 18345
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License Number State | MS
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