Provider Demographics
NPI:1275694317
Name:ERIC A. AWAD MD,LLC
Entity Type:Organization
Organization Name:ERIC A. AWAD MD,LLC
Other - Org Name:NEUROCARE CENTER OF ATLANTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-355-8804
Mailing Address - Street 1:2045 PEACHTREE RD NE STE 333
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1407
Mailing Address - Country:US
Mailing Address - Phone:404-355-8804
Mailing Address - Fax:404-355-1022
Practice Address - Street 1:2045 PEACHTREE RD NE STE 333
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1407
Practice Address - Country:US
Practice Address - Phone:404-355-8804
Practice Address - Fax:404-355-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF23714Medicare UPIN