Provider Demographics
NPI:1053056689
Name:AWAD, MAAN ABDULAZIZ H
Entity Type:Individual
Prefix:MR
First Name:MAAN
Middle Name:ABDULAZIZ H
Last Name:AWAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 IRWIN STREET
Mailing Address - Street 2:APARTMENT 5
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:681-285-8966
Mailing Address - Fax:
Practice Address - Street 1:101 STADIUM DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-7911
Practice Address - Country:US
Practice Address - Phone:304-598-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2023-02-23
Deactivation Date:2023-02-08
Deactivation Code:
Reactivation Date:2023-02-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program