Provider Demographics
NPI:1619970563
Name:NASHAWATI, EYAD (MD)
Entity Type:Individual
Prefix:
First Name:EYAD
Middle Name:
Last Name:NASHAWATI
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 1:2600 TUSCARAWAS ST W
Mailing Address - Street 2:STE 100
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-4696
Mailing Address - Country:US
Mailing Address - Phone:330-452-8844
Mailing Address - Fax:330-452-7012
Practice Address - Street 1:2600 TUSCARAWAS ST W
Practice Address - Street 2:STE 100
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-4696
Practice Address - Country:US
Practice Address - Phone:330-452-8844
Practice Address - Fax:330-452-7012
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-055866207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000134424OtherANTHEM BC/BS
OH0717326Medicaid
OH341574729EOtherAULTCARE
OH733559OtherBUCKEYE COMMUNITY HEALTH
OH341574729033OtherCARESOURCE
OHQ017022AOtherTHE HEALTH PLAN
OH000000186383OtherUNISON HEALTH PLAN
OHQ017022AOtherTHE HEALTH PLAN
OH000000186383OtherUNISON HEALTH PLAN
OHNA0698764Medicare PIN