Physician Compare National (NPI:1578631156)

HEALTHCARE PROVIDER: SOUSOU GAD AWAD MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1578631156
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6305939497
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070906000039
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AWAD
	Individual professional last name
Provider First Name	SOUSOU
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL PRACTICE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	NUCLEAR MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL PRACTICE, NUCLEAR MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	3515 W UNION HILLS DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 111
	Group Practice or individual's line 2 address
City	GLENDALE
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	853082430
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y