Provider Demographics
NPI:1598996415
Name:ALAWAD, AHMAD SAMER (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:SAMER
Last Name:ALAWAD
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:PO BOX 946383
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-6383
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:61 MEMORIAL MEDICAL PKWY STE 1-800B
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-5983
Practice Address - Country:US
Practice Address - Phone:386-586-1970
Practice Address - Fax:386-586-1971
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124843207RG0100X
MDD74008208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD053976700Medicaid
MDS062-0551OtherCAREFIRST BC/BS
MDS062-0551OtherCAREFIRST BC/BS