Provider Demographics
NPI:1508943192
Name:AWAD, ELIAS B (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:B
Last Name:AWAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:201 N WASHINGTON ST
Practice Address - Street 2:KAISER PERMANENTE FALLS CHURCH MEDICAL CENTER
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4518
Practice Address - Country:US
Practice Address - Phone:703-237-4000
Practice Address - Fax:703-531-1700
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-05-28
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Provider Licenses
StateLicense IDTaxonomies
DCMD039616207Q00000X
MDD0071559207Q00000X
VA0101233448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H34520Medicare UPIN
010655M92Medicare ID - Type Unspecified