Provider Demographics
NPI:1467632679
Name:M AWAD MD PA
Entity Type:Organization
Organization Name:M AWAD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEDHAT
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-578-2256
Mailing Address - Street 1:8395 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7301
Mailing Address - Country:US
Mailing Address - Phone:954-578-2258
Mailing Address - Fax:
Practice Address - Street 1:8395 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7301
Practice Address - Country:US
Practice Address - Phone:954-578-2258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70194207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty