MEDICARE: AMGAD NASHED-AWAD MD

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	207Q00000X	Family Medicine Physician	4301062666	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	700B510850	OTHER	MI	BCBS OF MI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518917491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMGAD NASHED-AWAD MD

Provider Business Mailing Address
First Line	:	PO BOX 1239
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48099-1239
Country	:	US
Telephone Number	:	248-824-6600
Fax Number	:	248-324-1477

Provider Business Practice Location Address
First Line	:	1985 GRATIOT BLVD
Second Line	:	SUITE 2A
City	:	MARYSVILLE
State	:	MI
Zip	:	48040-2215
Country	:	US
Telephone Number	:	810-364-5050
Fax Number	:	810-364-5688

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	10/24/2011

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