MEDICARE: KAY AWAD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	5601013237	MI

General Provider Information

NPI Number	:	1043028988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY AWAD

Provider Business Mailing Address
First Line	:	259 MACK AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2427
Country	:	US
Telephone Number	:	313-577-1716
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 MCAULEY DR
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48197-1051
Country	:	US
Telephone Number	:	734-712-3456
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/12/2025

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Directions to “ KAY AWAD ” Practice Location

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