Provider Demographics
NPI:1801821400
Name:ALAWI, FAIZAN M (DDS)
Entity Type:Individual
Prefix:
First Name:FAIZAN
Middle Name:M
Last Name:ALAWI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:FAIZAN
Other - Middle Name:MA
Other - Last Name:FAIZAN ALAWI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3400 SPRUCE STREET
Mailing Address - Street 2:2 RHOADS PAVILLION
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-2737
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:2 RHOADS PAVILION
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-2737
Practice Address - Fax:215-349-8339
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031568L207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019363570001Medicaid
U86877Medicare UPIN
PA050583Medicare PIN