Provider Demographics
NPI:1790747996
Name:ABDEL-GAWAD, AHMED (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ABDEL-GAWAD
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 1:400 BYRN ST SUITE A
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2076
Mailing Address - Country:US
Mailing Address - Phone:410-228-6161
Mailing Address - Fax:410-228-8396
Practice Address - Street 1:400 BYRN ST SUITE A
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2076
Practice Address - Country:US
Practice Address - Phone:410-228-6161
Practice Address - Fax:410-228-8396
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD50279208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD056548200Medicaid
G66527Medicare UPIN