MEDICARE: DR. MOHAMMAD BILAL AWAN M.D.

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	207R00000X	Internal Medicine Physician	305455-01	NY

General Provider Information

NPI Number	:	1235665647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD BILAL AWAN M.D.

Provider Business Mailing Address
First Line	:	4600 MILITARY RD STE A
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14305-1338
Country	:	US
Telephone Number	:	716-298-4050
Fax Number	:	716-298-4098

Provider Business Practice Location Address
First Line	:	4600 MILITARY RD
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14305-1338
Country	:	US
Telephone Number	:	716-298-4050
Fax Number	:	716-298-4098

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

Provider Enumeration Date	:	05/04/2017
Last Update Date	:	01/31/2024

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