Provider Demographics
NPI:1568667269
Name:AWAD-ALEXANDER, MARIE LINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:LINDA
Last Name:AWAD-ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8423 MARKET ST STE 205
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6778
Mailing Address - Country:US
Mailing Address - Phone:330-729-3125
Mailing Address - Fax:330-729-1861
Practice Address - Street 1:8423 MARKET ST STE 205
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6778
Practice Address - Country:US
Practice Address - Phone:330-729-3125
Practice Address - Fax:330-729-1861
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445711208600000X
OH35.099370208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0071350Medicaid
OHH163020Medicare PIN