Provider Demographics
NPI:1578557500
Name:AWAD, ERIC ADRIAN (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ADRIAN
Last Name:AWAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 333
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1407
Mailing Address - Country:US
Mailing Address - Phone:404-355-8804
Mailing Address - Fax:404-355-1022
Practice Address - Street 1:2045 PEACHTREE RD NE
Practice Address - Street 2:SUITE 333
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1407
Practice Address - Country:US
Practice Address - Phone:404-355-8804
Practice Address - Fax:404-355-1022
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA352032084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF23714Medicare UPIN