Provider Demographics
NPI:1376127159
Name:DAWOUD, FAKHRY MAGDY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:FAKHRY
Middle Name:MAGDY
Last Name:DAWOUD
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:BAVLY
Other - Middle Name:
Other - Last Name:DAWOUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:930 STEWART VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-8701
Mailing Address - Country:US
Mailing Address - Phone:615-955-2555
Mailing Address - Fax:
Practice Address - Street 1:530 NE GLEN OAK AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61637-0001
Practice Address - Country:US
Practice Address - Phone:309-655-2642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program