Provider Demographics
NPI:1093704488
Name:DAOUD, MILAD M (OD)
Entity Type:Individual
Prefix:DR
First Name:MILAD
Middle Name:M
Last Name:DAOUD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9173 ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3779
Mailing Address - Country:US
Mailing Address - Phone:724-861-4177
Mailing Address - Fax:724-861-9507
Practice Address - Street 1:9173 ROUTE 30
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-3779
Practice Address - Country:US
Practice Address - Phone:724-861-4177
Practice Address - Fax:724-861-9507
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000526152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015638530008Medicaid
PA0015638530008Medicaid
PAU59460Medicare UPIN