Provider Demographics
NPI:1285664607
Name:FAWZY, AHMED (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:FAWZY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20455 LORAIN RD
Mailing Address - Street 2:T01
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3494
Mailing Address - Country:US
Mailing Address - Phone:440-799-4224
Mailing Address - Fax:440-799-4228
Practice Address - Street 1:1170 E BROAD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6351
Practice Address - Country:US
Practice Address - Phone:440-323-3574
Practice Address - Fax:440-323-3552
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-07-6595F207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2227772Medicaid
OHH15427Medicare UPIN
OH2227772Medicaid