Provider Demographics
NPI:1639933252
Name:MIKHAIL, MELAD SABER MOAWAD
Entity Type:Individual
Prefix:
First Name:MELAD
Middle Name:SABER MOAWAD
Last Name:MIKHAIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 ASHLEY TOWN CENTER DR APT 639
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5692
Mailing Address - Country:US
Mailing Address - Phone:216-713-8394
Mailing Address - Fax:216-713-8394
Practice Address - Street 1:3100 ASHLEY TOWN CENTER DR APT 639
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5692
Practice Address - Country:US
Practice Address - Phone:216-713-8394
Practice Address - Fax:216-713-8394
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program