MEDICARE: DR. MEDHAT AHMED AWAD 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	ME70194	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275563827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEDHAT AHMED AWAD M.D.

Provider Business Mailing Address
First Line	:	8395 W OAKLAND PARK BLVD
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-7301
Country	:	US
Telephone Number	:	954-578-2256
Fax Number	:	954-742-4630

Provider Business Practice Location Address
First Line	:	8395 W OAKLAND PARK BLVD
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-7301
Country	:	US
Telephone Number	:	954-578-2256
Fax Number	:	954-742-4630

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	11/25/2020

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